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General NPI Number Information
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NPI Number | 1578960456
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Entity Type | Organization
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Legal Business Name | PATHOLOGY CONSULTANTS OF AUGUSTA, P.C.
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 3540 WHEELER RD SUITE 617
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City | AUGUSTA
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State | GA
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Zip | 30909-1871
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Country | US
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Telephone | 706-731-5831
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Fax | 706-731-5831
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Provider Business Mailing Address
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Address Line | 3540 WHEELER RD SUITE 617
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City | AUGUSTA
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State | GA
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Zip | 30909-1871
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Country | US
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Telephone | 706-731-5831
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Fax | 706-731-5831
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Authorized Official
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Title or Position | CEO
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Name | RICHARD K DOVER
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Credential | M.D.
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Telephone | 706-731-5831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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