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Organization

UNIVERSITY MEDICAL GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JULIE DEASON (DIRECTOR, PHYSICIAN REVENUE CYCLE)
(706) 774-8326
Entity
Organization

Contact information

Practice address
3121 PEACH ORCHARD RD STE 103, AUGUSTA, GA 30906-3531
(706) 792-5075
(706) 792-5085
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 774-7263
(706) 774-7230

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
208D00000X
General Practice Physician

Other

Enumeration date
02/29/2012
Last updated
05/07/2018
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