Provider Demographics
NPI: | 1548490550 |
---|---|
Name: | FRANCIS M. KUNDI, MD, PC |
Entity type: | Organization |
Organization Name: | FRANCIS M. KUNDI, MD, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER / PHYSICIAN |
Authorized Official - Prefix: | |
Authorized Official - First Name: | FRANCIS |
Authorized Official - Middle Name: | M |
Authorized Official - Last Name: | KUNDI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 229-985-1156 |
Mailing Address - Street 1: | PO BOX 6957 |
Mailing Address - Street 2: | |
Mailing Address - City: | MACON |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 31208-6957 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 229-985-1156 |
Mailing Address - Fax: | 229-985-2205 |
Practice Address - Street 1: | 14 HOSPITAL PARK |
Practice Address - Street 2: | |
Practice Address - City: | MOULTRIE |
Practice Address - State: | GA |
Practice Address - Zip Code: | 31768-6700 |
Practice Address - Country: | US |
Practice Address - Phone: | 229-985-1156 |
Practice Address - Fax: | 229-985-2205 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-07-24 |
Last Update Date: | 2009-07-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
GA | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty |