Individual
BOUNTHAVY HOMSOMBATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3675 J DEWEY GRAY CIR, SUITE 300, AUGUSTA, GA 30909-1868
(706) 863-9595
(888) 745-3917
Mailing address
PO BOX 3726, AUGUSTA, GA 30914-3726
(706) 863-9595
(888) 745-3917
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
68031
GA
2086S0102X
Surgical Critical Care Physician
Primary
068031
GA
2086S0102X
Surgical Critical Care Physician
117401
FL
2086S0102X
Surgical Critical Care Physician
MD0000063863
TN
2086S0102X
Surgical Critical Care Physician
MD35525
SC
2086S0102X
Surgical Critical Care Physician
Q6030
TX
Other
Enumeration date
11/03/2008
Last updated
03/07/2025
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