Provider Demographics
NPI:1851708218
Name:MACON ORTHOPAEDIC & HAND CENTER PA
Entity Type:Organization
Organization Name:MACON ORTHOPAEDIC & HAND CENTER PA
Other - Org Name:ORTHOGEORGIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:478-254-5301
Mailing Address - Street 1:717 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4818
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:717 S 8TH ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4818
Practice Address - Country:US
Practice Address - Phone:770-227-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0652540001Medicare NSC
GRP1302Medicare PIN