Provider Demographics
NPI:1457703175
Name:MACON ORTHOPAEDIC & HAND CENTER PA
Entity Type:Organization
Organization Name:MACON ORTHOPAEDIC & HAND CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BILL
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-254-5301
Mailing Address - Street 1:1118 MORNINGSIDE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-4948
Mailing Address - Country:US
Mailing Address - Phone:478-745-4206
Mailing Address - Fax:
Practice Address - Street 1:1118 MORNINGSIDE DR
Practice Address - Street 2:SUITE B
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-4948
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:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0652540003Medicare NSC
GRP1302Medicare UPIN