MEDICARE: OCONEE PROSTHETICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224P00000X	Prosthetist

General Provider Information

NPI Number	:	1396332847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCONEE PROSTHETICS LLC

Provider Business Mailing Address
First Line	:	PO BOX 1714
Second Line	:
City	:	WATKINSVILLE
State	:	GA
Zip	:	30677-0034
Country	:	US
Telephone Number	:	706-850-3883
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 BARBER CREEK DR STE 103
Second Line	:
City	:	WATKINSVILLE
State	:	GA
Zip	:	30677-4502
Country	:	US
Telephone Number	:	706-850-3883
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ZACHARY T HUGHES
Credential	:	LCP
Telephone Number	:	706-850-3883

Provider Enumeration Date	:	12/30/2020
Last Update Date	:	03/06/2021

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Directions to “OCONEE PROSTHETICS LLC ” Practice Location

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