# COLORECTAL SURGERY ASSOCIATES P C

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

## Provider details

- **NPI number:** 1801083811
- **Authorized official:** DOUGLAS ALAN BREWER (MD)
- **Authorized official phone:** (478) 471-1943

## Contact information

- **Practice address:** 240 SHERATON BLVD, MACON, GA 31210-1358
- **Practice address phone:** (478) 471-1943
- **Practice address fax:** (478) 475-9780
- **Mailing address:** 240 SHERATON BLVD, MACON, GA 31210-1358
- **Mailing address phone:** (478) 471-1943
- **Mailing address fax:** (478) 475-9780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208C00000X | Colon & Rectal Surgery Physician | 005329 | GA | — |
| 208C00000X | Colon & Rectal Surgery Physician | 38696 | GA | Yes |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 10/03/2007
- **Last updated:** 02/05/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000622916B | — | GA |
| 05 | — | 300032589D | — | GA |