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General NPI Number Information
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NPI Number | 1689707432
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Entity Type | Organization
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Legal Business Name | AUGUSTA GASTROINTESTINAL SPECIALISTS INC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 820 SAINT SEBASTIAN WAY SUITE 2 D
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City | AUGUSTA
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State | GA
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Zip | 30901-2643
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Country | US
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Telephone | 706-722-1461
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Fax | 706-722-2767
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Provider Business Mailing Address
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Address Line | 820 SAINT SEBASTIAN WAY SUITE 2 D
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City | AUGUSTA
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State | GA
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Zip | 30901-2643
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Country | US
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Telephone | 706-722-1461
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Fax | 706-722-2767
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Authorized Official
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Title or Position | OWNER, CEO
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Name | DR. RONALD BROWN SR.
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Credential | M.D.
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Telephone | 706-722-1461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G025517
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 048164
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License Number State | GA
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