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General NPI Number Information
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NPI Number | 1154449643
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Entity Type | Organization
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Legal Business Name | AUGUSTA EYE SURGERY, LLC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 905 STEVENS CREEK RD
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City | AUGUSTA
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State | GA
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Zip | 30907-3201
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Country | US
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Telephone | 706-922-6000
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Fax | 706-722-7994
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Provider Business Mailing Address
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Address Line | 905 STEVENS CREEK RD
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City | AUGUSTA
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State | GA
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Zip | 30907-3201
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Country | US
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Telephone | 706-922-6000
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Fax | 706-722-7994
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MICHELLE ROGERS
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Credential | COE
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Telephone | 706-922-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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