Provider Demographics
NPI:1164464756
Name:MACON-BIBB COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MACON-BIBB COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-751-6303
Mailing Address - Street 1:201 2ND ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-6328
Mailing Address - Country:US
Mailing Address - Phone:782-975-1904
Mailing Address - Fax:478-751-6099
Practice Address - Street 1:1600 FORSYTH ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1408
Practice Address - Country:US
Practice Address - Phone:478-745-0411
Practice Address - Fax:478-749-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00219381BMedicaid
GA00733125AMedicaid
GA00859933AMedicaid
GA300036340BMedicaid
GA916309744BMedicaid
GA00655003BMedicaid
GA000495547DMedicaid
GA00051961CMedicaid
GA000770624CMedicaid
GA00452944BMedicaid
GA00560975AMedicaid
GA300036340HMedicaid
GA00193234CMedicaid
GA00456541LMedicaid
GA00460336CMedicaid
GA071337877AMedicaid
GA000309878DMedicaid
GA300036340AMedicaid