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General NPI Number Information
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NPI Number | 1104987957
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Entity Type | Organization
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Legal Business Name | EYE SURGERY CENTER OF AUGUSTA, LLC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 3658 J DEWEY GRAY CIR
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City | AUGUSTA
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State | GA
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Zip | 30909-6424
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Country | US
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Telephone | 706-651-3937
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Fax | 706-863-3102
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Provider Business Mailing Address
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Address Line | 3658 J DEWEY GRAY CIR
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City | AUGUSTA
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State | GA
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Zip | 30909-6424
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Country | US
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Telephone | 706-651-2020
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Fax | 706-651-2032
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE ALLEN BROWN
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Credential | M.D.
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Telephone | 706-651-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 121167
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License Number State | GA
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