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General NPI Number Information
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NPI Number | 1669579934
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Entity Type | Organization
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Legal Business Name | AUGUSTA EAR NOSE &THROAT SPECIALISTS, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 70 MEDICAL CENTER CIR SUITE 210
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2273
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Country | US
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Telephone | 540-245-7027
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Fax | 540-245-7027
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Provider Business Mailing Address
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Address Line | 141 WOODLAND DR
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City | STAUNTON
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State | VA
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Zip | 24401-2370
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Country | US
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Telephone | 540-538-5792
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE MANAGER
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Name | MRS. CAREY KEEFE
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Credential |
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Telephone | 540-538-6792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 0101043485
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License Number State | VA
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