Organization
ATYS B COPE, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATYS B COPE MD (MD/PRESIDENT)
(912) 764-8080
Entity
Organization
Contact information
Practice address
81 E JONES AVE, STATESBORO, GA 30458-2919
(912) 764-8080
(912) 764-8083
Mailing address
PO BOX 239, 81 EAST JONES AVE, STATESBORO, GA 30459-0239
(912) 764-8080
(912) 764-8083
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
052160
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
597816045A
—
GA
Enumeration date
09/28/2006
Last updated
05/23/2008
Update your record
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