Healthcare Provider Details

I. General information

NPI: 1578480794
Provider Name (Legal Business Name): GCO ANCILLARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 J DEWEY GRAY CIR
AUGUSTA GA
30909-1867
US

IV. Provider business mailing address

3650 J DEWEY GRAY CIR
AUGUSTA GA
30909-1867
US

V. Phone/Fax

Practice location:
  • Phone: 706-863-9797
  • Fax: 706-860-7686
Mailing address:
  • Phone: 706-863-9797
  • Fax: 706-860-7686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD POPE
Title or Position: CO-PRESIDENT
Credential: MD
Phone: 706-691-3070