Christian M Ezekwueche, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

024808 Issued in GA

Practice address

770 Pine St
Suite 560
Macon, GA 31201-2173

Phone

(478) 741-5155

Fax

(478) 746-9682

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1366421372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST",
            "address_2": "SUITE 560",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012173",
            "telephone_number": "478-741-5155",
            "fax_number": "478-746-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST",
            "address_2": "SUITE 560",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012173",
            "telephone_number": "478-741-5155",
            "fax_number": "478-746-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEKWUECHE",
        "first_name": "CHRISTIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "024808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Center of Central Georgia, PC
• Eye Physicians Professional Association
• Harry Onoriode Eyituoyo, MD
• Chioma Eze-Njoku
• Ngozi Iheuwa Ezeh, MD, RPA-C
• Sondralyn M Fackler, MD
• William Keith Fackler, MD
• Fadoul Medical LLC
• Peter Sami Fadoul, MD
• Catherine Faircloth, NP

• Specialist in Macon, GA
• Providers in Macon, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.