Provider Demographics
NPI:1417017989
Name:GENC, AYSE F (MD)
Entity Type:Individual
Prefix:DR
First Name:AYSE
Middle Name:F
Last Name:GENC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-3357
Mailing Address - Country:US
Mailing Address - Phone:478-633-6706
Mailing Address - Fax:478-633-5384
Practice Address - Street 1:777 HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2102
Practice Address - Country:US
Practice Address - Phone:478-633-6706
Practice Address - Fax:478-633-5384
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050882207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA961049781CMedicaid
GAP00216323OtherRAIL ROAD MEDICARE - HEM
GAP00300408OtherRAIL ROAD MEDICARE - NEX
GAP00300408OtherRAIL ROAD MEDICARE - NEX
GABG8748759OtherDEA #
GAP00216323OtherRAIL ROAD MEDICARE - HEM
GAP00300408OtherRAIL ROAD MEDICARE - NEX
GA05BDKGZMedicare ID - Type UnspecifiedNEXUS