Mppg, Inc.

NPI #1174691067 in Vidalia, Georgia

Provider Information

NPI Number
1174691067
Entity Type
Organization
Organization Name
Mppg, Inc.
Primary Specialty
Surgery - Vascular Surgery
Enumeration Date
Dec 1, 2006
Last Updated
Jun 1, 2011

Practice Location

Address
200 MAPLE DRIVE
State
Georgia
ZIP Code
30474
Phone
(912) 350-5961

Authorized Official

Name
ROBIN J. MADDOX
Title
PROVIDER ENROLLMENT COORDINATOR
Phone
(912) 350-9335

Specialties & Taxonomy Codes

Specialty
Radiology - Vascular & Interventional RadiologyVascular & Interventional Radiology
Surgery - Vascular SurgeryVascular Surgery

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