Provider Demographics
NPI:1427115864
Name:ISRAEL, NOEL RAYMUND (MD)
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:RAYMUND
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1062 FORSYTH ST STE 2E
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-8631
Mailing Address - Country:US
Mailing Address - Phone:478-633-7330
Mailing Address - Fax:478-633-7360
Practice Address - Street 1:1062 FORSYTH ST STE 2E
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8631
Practice Address - Country:US
Practice Address - Phone:478-633-7330
Practice Address - Fax:478-633-7360
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2020-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0359112080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000657456DMedicaid
GA000657456DMedicaid