Healthcare Provider Details

I. General information

NPI: 1346681921
Provider Name (Legal Business Name): CPC-CENTRAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3614 J DEWEY GRAY CIR STE D
AUGUSTA GA
30909-6512
US

IV. Provider business mailing address

PO BOX 1967
EVANS GA
30809-1967
US

V. Phone/Fax

Practice location:
  • Phone: 706-868-7380
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH HOOPER
Title or Position: MD
Credential:
Phone: 706-868-7380