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General NPI Number Information
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NPI Number | 1255163614
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Entity Type | Organization
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Legal Business Name | AUGUSTA ONCOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 08/15/2024
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 150 BLUFF AVE
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3862
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Country | US
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Telephone | 706-736-1830
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Fax |
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Provider Business Mailing Address
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Address Line | 3696 WHEELER RD
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City | AUGUSTA
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State | GA
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Zip | 30909-6520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DAVID RONALD SQUIRES
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Credential | MD
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Telephone | 706-736-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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