Organization
CSRA MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MERRYLL LYNNETTE WASHINGTON (OFFICE MANAGER)
(706) 736-8519
Entity
Organization
Contact information
Practice address
2123 WRIGHTSBORO RD, AUGUSTA, GA 30904-4777
(706) 736-5244
(706) 736-5246
Mailing address
2123 WRIGHTSBORO RD, AUGUSTA, GA 30904-4777
(706) 736-5244
(706) 736-5246
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85001833G
—
GA
05
—
GPA645
—
SC
Enumeration date
08/25/2006
Last updated
12/14/2010
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