Macon, Michael G
Macon, Michael G is an individual health care provider with primary practice located at 7700 E Florentine Rd Bldg B, Ste 203, Prescott Valley AZ 86314-2245. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Macon, Michael G can be contacted via phone (928) 442-8740.Contact Information
Primary practice address
7700 E Florentine Rd Bldg B, Ste 203
Prescott Valley AZ 86314-2245
Phone: (928) 442-8740
Fax: (928) 442-8142
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | D0030763 | Maryland |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 53388 | Arizona |
Profile Details
| NPI number | 1174526222 |
|---|---|
| LBN Legal business name | Macon, Michael G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2005 |
| Last updated | Feb 21st, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174526222 | NPPES |
| Arizona | MEDICAID | 218939 | |
| Arizona | MEDICAID | 126571700 |
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