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General NPI Number Information
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NPI Number | 1407297757
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Entity Type | Organization
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Legal Business Name | GA MASTERS EMERGENCY PHYSICIANS LLC
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Dates
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Enumeration Date | 07/16/2013
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 3651 WHEELER RD
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City | AUGUSTA
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State | GA
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Zip | 30909-6521
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Country | US
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Telephone | 706-651-3232
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37954
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City | PHILADELPHIA
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State | PA
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Zip | 19101
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Country | US
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Telephone | 800-355-0808
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT/ ANCILLARY SERVICES
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Name | ROSS RONAN
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Credential |
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Telephone | 303-495-1263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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