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NPI Code Detail

MEDICARE: AUGUSTA REHABILITATION ASSOCIATES, P.C.

MEDICARE: AUGUSTA REHABILITATION ASSOCIATES, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1215963483
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUGUSTA REHABILITATION ASSOCIATES, P.C.
Provider Business Mailing Address
First Line : 630 13TH ST
Second Line : SUITE 100
City : AUGUSTA
State : GA
Zip : 30901-1015
Country : US
Telephone Number : 706-722-7239
Fax Number : 706-722-6566
Provider Business Practice Location Address
First Line : 630 13TH ST
Second Line : SUITE 100
City : AUGUSTA
State : GA
Zip : 30901-1015
Country : US
Telephone Number : 706-722-7239
Fax Number : 706-722-6566
Authorized Official
Title or Position : PRACTICE MANAGER
Name : RONALD OWEN MCDEARIS
Credential :
Telephone Number : 706-722-7239
Provider Enumeration Date : 06/22/2006
Last Update Date : 08/22/2020

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