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Contact Information

MACON MEDICAL CLINIC, LLC.
3350 NORTHSIDE DR
MACON, GA31210-2504
 Phone: 478-405-2121
 Fax: 478-405-0114
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

261QP2300X
 

Health Service

261QH0100X
 

Medical Specialty

261QM2500X
Indicates primary specialty

NPI Profile & details for MACON MEDICAL CLINIC, LLC.

NPI # 1063823482
LBN Legal business name MACON MEDICAL CLINIC, LLC.
Authorized official MOHAMMAD RAHMAN - (PROVIDER/PHYSICIAN/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/20/2014
Last updated 05/20/2014 - About 12 years ago
Identifiers
GA License # 044065
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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