Healthcare Provider Details

I. General information

NPI: 1295984110
Provider Name (Legal Business Name): AUGUSTA ONCOLOGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 DANTIGNAC ST STE 1000
AUGUSTA GA
30901-2776
US

IV. Provider business mailing address

3696 WHEELER RD
AUGUSTA GA
30909-6520
US

V. Phone/Fax

Practice location:
  • Phone: 706-736-1830
  • Fax:
Mailing address:
  • Phone: 706-736-1830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

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