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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174526222 NPPES
Arizona MEDICAID 218939
Arizona MEDICAID 126571700

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