Provider Demographics
NPI:1851379259
Name:TINDOL, GEORGE ALLEN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALLEN
Last Name:TINDOL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:250 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-3490
Mailing Address - Country:US
Mailing Address - Phone:478-301-2362
Mailing Address - Fax:478-301-2272
Practice Address - Street 1:707 PINE ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2106
Practice Address - Country:US
Practice Address - Phone:478-301-5800
Practice Address - Fax:478-301-5812
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA035344207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52506454-002OtherBCBS
GA1044681OtherFIRST HEALTH
GA5076263OtherAETNA
GA000544079CMedicaid
GA000544079IMedicaid
GA1162681OtherUNITED HEALTHCARE
GAP01057600OtherRAILROAD MEDICARE
GA11BDVNWMedicare ID - Type Unspecified
GA1162681OtherUNITED HEALTHCARE
GA000544079CMedicaid