Individual
MS. LAUREN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-5205
Mailing address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007764
GA
363AM0700X
Medical Physician Assistant
35399
GA
Other
Enumeration date
10/01/2015
Last updated
03/06/2024
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