Organization
SPINE CENTER AUGUSTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN WEIDLER (CFO)
(404) 351-5812
Entity
Organization
Contact information
Practice address
501 FURYS FERRY RD, AUGUSTA, GA 30907-9059
(706) 715-2897
Mailing address
3161 HOWELL MILL RD NW STE 310, ATLANTA, GA 30327-2132
(404) 351-5812
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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