Healthcare Provider Details

I. General information

NPI: 1316205198
Provider Name (Legal Business Name): GEORGIA HEALTH SCIENCES UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 04/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST DEPARTMENT OF NEONATOLOGY
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1120 15TH ST DEPARTMENT OF NEONATOLOGY
AUGUSTA GA
30912-0004
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2286
  • Fax:
Mailing address:
  • Phone: 706-721-2286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberRN214814
License Number StateGA

VIII. Authorized Official

Name: DR. JATINDER BHATIA
Title or Position: NEONATOLOGY SECTION CHIEF
Credential: M.D.
Phone: 706-721-2231