Central Georgia Gynecology LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

CENTRAL GEORGIA GYNECOLOGY LLC

Practice address

770 Pine Street
Suitte 580
Macon, GA 31201-7532

Phone

(478) 960-7747

Fax

(478) 746-0022

NPI assigned

Jun 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Henry Jackson Davis, MD

Title

President

Phone

(478) 960-7747

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leslie G Tidwell, MD

  • Family Medicine Physician
  • Macon, GA
  • NPI 1568419216

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1407015365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 27690",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312217690",
            "telephone_number": "478-960-7747",
            "fax_number": "478-746-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE STREET",
            "address_2": "SUITTE 580",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017532",
            "telephone_number": "478-960-7747",
            "fax_number": "478-746-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL GEORGIA GYNECOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-960-7747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Central Georgia Gynecology II LLC
• Central Georgia Health Ventures, Inc
• Central Georgia Heart Center, PC
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• Central Georgia Home Care Services, Inc.
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• Gynecology Physician in Macon, GA
• Providers in Macon, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.