Healthcare Provider Details

I. General information

NPI: 1144967522
Provider Name (Legal Business Name): AUGUSTA ONCOLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 01/29/2024
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 GEORGE C. WILSON DRIVE
AUGUSTA GA
30909
US

IV. Provider business mailing address

1220 GEORGE C. WILSON DRIVE
AUGUSTA GA
30909
US

V. Phone/Fax

Practice location:
  • Phone: 706-941-8206
  • Fax: 866-924-4429
Mailing address:
  • Phone: 706-941-8206
  • Fax: 866-924-4429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MIRIAM YVETTE ATKINS
Title or Position: PARTNER
Credential: MD
Phone: 706-736-1830