Healthcare Provider Details

I. General information

NPI: 1780548883
Provider Name (Legal Business Name): CENTRAL GA UROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HILLCREST PKWY
DUBLIN GA
31021-4208
US

IV. Provider business mailing address

1000 HILLCREST PKWY
DUBLIN GA
31021-4208
US

V. Phone/Fax

Practice location:
  • Phone: 478-334-2800
  • Fax:
Mailing address:
  • Phone: 478-334-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY BARNES
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 478-334-2800