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General NPI Number Information
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NPI Number | 1740448885
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Entity Type | Organization
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Legal Business Name | ANESTHESIA PROVIDERS OF AUGUSTA, INC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 215 MIMS RD
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City | SYLVANIA
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State | GA
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Zip | 30467-1994
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Country | US
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Telephone | 706-868-0131
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Fax | 706-854-0131
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Provider Business Mailing Address
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Address Line | PO BOX 12001
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City | AUGUSTA
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State | GA
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Zip | 30914-2001
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Country | US
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Telephone | 706-868-0131
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Fax | 706-854-0131
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Authorized Official
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Title or Position | SOUL OWNER
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Name | SHANNON M THOMAS
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Credential | C.R.N.A.
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Telephone | 706-836-4915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN112820
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License Number State | GA
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