Organization
EYE SURGERY CENTER OF AUGUSTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ALLEN BROWN (PRESIDENT)
(706) 651-2020
Entity
Organization
Contact information
Practice address
3658 J DEWEY GRAY CIR, AUGUSTA, GA 30909-6424
(706) 651-3937
(706) 863-3102
Mailing address
3658 J DEWEY GRAY CIR, AUGUSTA, GA 30909-6424
(706) 651-2020
(706) 651-2032
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
121167
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00830101A
—
GA
01
—
10040055
AMERIGROUP MGD MEDICAID
—
01
—
2189908
AETNA HMO
—
01
—
324827
WELLCARE MANAGED MEDICAID
—
01
—
7300002
AETNA PPO, STANDARD
—
05
—
ASC020
—
SC
Enumeration date
12/13/2006
Last updated
12/15/2025
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