Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ketamine Centers of Central Georgia LLC

Organization Internal Medicine Physician · NPI 1053132308

Ketamine Centers of Central Georgia LLC is an Internal Medicine Physician in Macon, Georgia. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3312 Northside Dr Ste D235
Macon, GA 31210-0426
Phone: (478) 201-9220
Fax: (478) 203-9322
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1053132308
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Judah Greenberg — Doctor Owner · (478) 201-9220
Other names Ketamine Center Of Central Georgia
NPI enumeratedOctober 21, 2024
Last updated in NPPESOctober 21, 2024
Certification dateOctober 20, 2024
Mailing address6275 Rivoli Dr, Macon, GA 31210-1456

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