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1386753754
TIMOTHY LONGAKER
MACON, GA
NPI
1386753754
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: GA 025883)
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
TIMOTHY LONGAKER MD
777 HEMLOCK ST HB 64
MACON, GA 31201-2102
Phone number: 478-633-2097
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Mailing Address
TIMOTHY LONGAKER MD
175 RIVOLI DOWNS DR
MACON, GA 31210-8611
Phone number: 478-477-5480
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