Augusta Ent PC
Specialist in Thomson, GA. Organization (NPI-2).
NPI number1043377005
StatusActive
Last updated in NPPESMay 14, 2008
Details
- NPI
- 1043377005
- Entity type
- Organization (NPI-2)
- Legal business name
- Augusta Ent PC
- Organization subpart
- No
- Enumeration date
- Jan 2, 2007
- Last updated
- May 14, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
315 Fluker StThomson, GA 30824-2108
Phone 706-868-5676 · Fax 706-722-2824
Mailing address
340 N Belair RdEvans, GA 30809-3000
Phone 706-868-5676 · Fax 706-722-2824
Authorized official
Jammie Lee Sparks
Billing Supervisor
7068685676
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