Macon Gynecologic Oncology LLC

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

License

73005 Issued in GA

Legal business name

MACON GYNECOLOGIC ONCOLOGY LLC

Practice address

770 Pine St Ste 210
Macon, GA 31201-7512

Phone

(478) 845-7630

Fax

(478) 216-9178

NPI assigned

Dec 3, 2015

Organization subpart

No

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

Authorized official

Name

Michael B Dillon, MDNPI 1346314069

Title

Provider

Phone

(478) 845-7630

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 9

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

• Michael B Dillon, MD

  • Gynecologic Oncology Physician
  • Macon, GA
  • NPI 1346314069
  Medicare reassignment NPD Authorized official
• Paris Bailey Brock, MD

  • Student in an Organized Health Care Education/Training Program
  • Macon, GA
  • NPI 1447198742
  NPD (past)
• Bernard Emuze, MD

  • Student in an Organized Health Care Education/Training Program
  • Macon, GA
  • NPI 1720848179
  NPD (past)
• Khadijat Omokosefowora Kasumu, MD

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1881397974
  NPD (past)
• Elias Adedamola Lawal, MD

  • Student in an Organized Health Care Education/Training Program
  • Macon, GA
  • NPI 1912601774
  NPD (past)
• Jamal Malik

  • Student in an Organized Health Care Education/Training Program
  • Macon, GA
  • NPI 1457290611
  NPD (past)
• Alexander Sabol, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1316794803
  NPD (past)
• Tyler Harris Yeomans, MD

  • Emergency Medicine Physician
  • Macon, GA
  • NPI 1144812165
  NPD (past)
• Christopher Robin Denham, MD

  • Psychiatry Physician
  • Twin Falls, ID
  • NPI 1336775204
  NPD (past)

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554768000000",
    "number": "1922473859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 210",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017512",
            "telephone_number": "478-845-7630",
            "fax_number": "478-216-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 210",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017512",
            "telephone_number": "478-845-7630",
            "fax_number": "478-216-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON GYNECOLOGIC ONCOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-03",
        "last_updated": "2019-04-09",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "478-845-7630",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "GA",
            "license": "73005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macon Family Health Center Inc
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• Macon Gastroenterology Anesthesia Associates LLC
• Macon GYN OB Associates II, LLC
• Macon GYN/OB Associates
• Macon Healthcare LLC
• Macon Kidney Institute
• Macon Lung Center PC
• Macon Medical Clinic, LLC.
• Macon Medical Group PC

• Gynecologic Oncology Physician in Macon, GA
• Providers in Macon, GA by specialty
• Gynecologic Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.