Provider Demographics
NPI:1093480964
Name:MACON FAMILY MEDICAL CARE, PLLC
Entity Type:Organization
Organization Name:MACON FAMILY MEDICAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:CREEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:828-576-7058
Mailing Address - Street 1:36 WESTGATE PLZ
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-1422
Mailing Address - Country:US
Mailing Address - Phone:828-576-7058
Mailing Address - Fax:828-419-7721
Practice Address - Street 1:36 WESTGATE PLZ
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-1422
Practice Address - Country:US
Practice Address - Phone:828-576-7058
Practice Address - Fax:828-419-7721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty