MEDICARE: DR. ALLEN GARRISON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	054017	GA

General Provider Information

NPI Number	:	1689752636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN GARRISON M.D.

Provider Business Mailing Address
First Line	:	6501 PEAKE RD
Second Line	:	#700
City	:	MACON
State	:	GA
Zip	:	31210-8042
Country	:	US
Telephone Number	:	478-476-9285
Fax Number	:	478-474-9034

Provider Business Practice Location Address
First Line	:	6501 PEAKE RD
Second Line	:	#700
City	:	MACON
State	:	GA
Zip	:	31210-8042
Country	:	US
Telephone Number	:	478-476-9285
Fax Number	:	478-474-9034

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. ALLEN GARRISON M.D.” Practice Location

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