Healthcare Provider Details

I. General information

NPI: 1891744322
Provider Name (Legal Business Name): NEPHROLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GREENE ST STE 200
AUGUSTA GA
30901-2385
US

IV. Provider business mailing address

701 GREENE ST STE 200
AUGUSTA GA
30901-2385
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-6900
  • Fax: 706-722-5118
Mailing address:
  • Phone: 706-722-6900
  • Fax: 706-722-5118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: BARTON C BREZINA
Title or Position: DIRECTOR
Credential: M.D.
Phone: 706-722-6900