Macon Medical Enterprises LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

18D2031301 Issued in KY

Legal business name

MACON MEDICAL ENTERPRISES LLC

Practice address

43 Waco Drive
Suit 7
London, KY 40741

Phone

(606) 878-1064

NPI assigned

Dec 19, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffery Hensley

Title

Manager

Phone

(606) 878-1064

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1245509447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WACO DRIVE",
            "address_2": "SUIT 7",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "40741",
            "telephone_number": "606-878-1064",
            "fax_number": "606-878-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WACO DRIVE",
            "address_2": "SUIT 7",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "40741",
            "telephone_number": "606-878-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON MEDICAL ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "HENSLEY",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "606-878-1064"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": "18D2031301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reagen M Loughran, ARNP
• Clifford Lowdenback, DMD
• Nina Ngwa Lum, M.D.
• Nathan Lundy
• Rebecca Lynch
• Amber Madden, LPCC
• Sridevi Maddineni, M.D.
• Henry M Magee, O.D.
• Karla Gail Maggard, APRN, FNP-BC
• Michael Brent Maggard, D.M.D., M.S.D

• Clinical Medical Laboratory in London, KY
• Providers in London, KY by specialty
• Clinical Medical Laboratory in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.