# UNIVERSITY PRIMARY CARE AIKEN, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UMG Primary Care Aiken
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609137702
- **Authorized official:** JULIE DEASON (DIRECTOR REVENUE CYCLE)
- **Authorized official phone:** (706) 774-7263

## Contact information

- **Practice address:** 5110 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3814
- **Practice address phone:** (803) 643-0588
- **Practice address fax:** (706) 774-7230
- **Mailing address:** PO BOX 1705, AUGUSTA, GA 30903-1705
- **Mailing address phone:** (706) 774-7263
- **Mailing address fax:** (706) 774-7230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 06/05/2012
- **Last updated:** 10/16/2012