Organization
AUGUSTA PLASTIC SURGERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARON P BARTLEY (BILLING MANAGER)
(706) 724-5611
Entity
Organization
Contact information
Practice address
569 FURYS FERRY RD, MARTINEZ, GA 30907-9059
(706) 724-5611
(706) 724-5435
Mailing address
569 FURYS FERRY RD, MARTINEZ, GA 30907-9059
(706) 724-5611
(706) 724-5435
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
121-114
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000728472A
—
GA
05
—
ASC009
—
SC
Enumeration date
11/21/2005
Last updated
07/22/2020
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