Organization
AUGUSTA AESTHETIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY BENTON WILLIAMSON MD (OWNER)
(706) 737-8827
Entity
Organization
Contact information
Practice address
2258 WRIGHTSBORO ROAD SUITE 180, AUGUSTA, GA 30904
(706) 737-8827
(706) 737-8916
Mailing address
2258 WRIGHTSBORO ROAD SUITE 180, AUGUSTA, GA 30904
(706) 737-8827
(706) 737-8916
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
121224
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51003458
BCBS
GA
01
—
6749808
CIGNA
—
Enumeration date
07/12/2006
Last updated
08/22/2020
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