Augusta University

NPI #1215711155 in Augusta, Georgia

Provider Information

NPI Number
1215711155
Entity Type
Organization
Organization Name
Augusta University
Primary Specialty
Family Medicine - Sports Medicine
Enumeration Date
Aug 22, 2023
Last Updated
Aug 22, 2023

Practice Location

Address
1120 15TH ST # B132
State
Georgia
ZIP Code
30912-0004
Phone
(972) 367-4845

Authorized Official

Name
MR. MOUZON BASS III
Title
ADMINISTRATOR/AGENT
Phone
(972) 367-4845

Specialties & Taxonomy Codes

Specialty
Family Medicine - Sports MedicineSports Medicine

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