Healthcare Provider Details
I. General information
NPI: 1669410569
Provider Name (Legal Business Name): WEST AUGUSTA OBSTETRICS & GYNECOLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1126 MEDICAL CENTER DR
AUGUSTA GA
30909-1810
US
IV. Provider business mailing address
1126 MEDICAL CENTER DR
AUGUSTA GA
30909-1810
US
V. Phone/Fax
- Phone: 706-863-5082
- Fax: 706-863-4082
- Phone: 706-863-5082
- Fax: 706-863-4082
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SUSAN
THOMAS
BRIDGES
Title or Position: OWNER
Credential: M.D.
Phone: 706-863-5082