# MANTILLA SURGICAL COLORECTAL & PELVIC HEALTH PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013827567
- **Authorized official:** NATHALIE MANTILLA MD, MPH (PRESIDENT/CEO)
- **Authorized official phone:** (312) 927-5299

## Contact information

- **Practice address:** 1109 MEDICAL CENTER DR STE 3, AUGUSTA, GA 30909-6644
- **Practice address phone:** (312) 927-5299
- **Mailing address:** 728 MICHAELS CRK, EVANS, GA 30809-4042
- **Mailing address phone:** (312) 927-5299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | Yes |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2026
- **Last updated:** 10/09/2026