Organization
UNIVERSITY MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE DEASON (DIRECTOR PHYSICIAN REVENUE CYCLE)
(706) 774-8326
Entity
Organization
Contact information
Practice address
309 WEST AVE, NORTH AUGUSTA, SC 29841-3800
(803) 279-1412
(706) 774-7230
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 774-7263
(706) 774-7230
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
02/13/2012
Last updated
12/28/2017
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