PAUL R. PHELPS, SR, M.D., PC
Osteopathic Medicine at Forsyth St, Macon, GA

License number
Georgia 011990
Category
Osteopathic Medicine
Type
Emergency Medicine
Owner
Name: TAMMY J BRICKLE
Title: BILLING AGENT
Phone: (478) 254-5943
Address
Address
818 Forsyth St, Macon, GA 31201
National Provider ID: 1013234541
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PAUL R. PHELPS, SR., M.D., PC

330 Hospital Dr STE 201, Macon, GA

Status:
Inactive
Registration:
Jun 16, 1978
Inactive since:
Jul 9, 2005
State ID:
H806051
Business type:
Domestic Profit Corporation
Secretarys:
R Paul Sr (CEO), 330 Hospital Dr STE C201, Macon, GA (Physical),Connie Phelps (Secretary), 330 Hospital Dr STE C201, Macon, GA (Physical)
Agent:
Paul R Sr Md Phelps,330 Hospital Dr STE C201, Macon, GA 31217 (Physical)

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