Vernon, Minor C

Vernon, Minor C is an individual health care provider with primary practice located at 3951 Ridge Ave Ste A, Macon GA 31210-5050. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Vernon, Minor C can be contacted via phone (478) 475-1006.

Contact Information

Primary practice address
3951 Ridge Ave Ste A Macon GA 31210-5050
Fax: (478) 475-0787
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 020359 Georgia

Profile Details

NPI number 1730171828
LBN Legal business name Vernon, Minor C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Jul 9th, 2007 - about 18 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 1730171828 NPPES
Georgia Other 4417613 AETNA PPO NUMBER
Georgia Other 572632 AETNA PPO NUMBER
Georgia Other 1200048 AETNA PPO NUMBER
Georgia MEDICAID 00249213C AETNA PPO NUMBER

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