MACON OUTPATIENT SURGERY INC NPI 1104072453

NPI Information

NPI: 1104072453
Provider Name: MACON OUTPATIENT SURGERY INC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
3708 NORTHSIDE DR
MACON, GA
ZIP 31210
Phone: (478) 745-4206
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MACON OUTPATIENT SURGERY INC is an ambulatory surgical clinic center in Macon, GA. MACON OUTPATIENT SURGERY INC NPI is 1104072453. The provider is registered as an organization entity type.

The provider's business location address is:

3708 NORTHSIDE DR
MACON, GA
ZIP 31210-404
Phone: (478) 745-4206
Fax: (478) 254-5463

The provider's authorized official is Georgia Lee .
The authorized official title is Chief Operating Officer and has the following contact phone number (478) 745-4206.

The enumeration date for this NPI number is 8/18/2008 and was last updated on 1/3/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00821697A	MEDICAID	GEORGIA
2	X47053	MEDICARE UPIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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