Organization
CSRA SURGICAL SOLUTIONS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON WILDER (INS BILLING DEPT)
(706) 863-9595
Entity
Organization
Contact information
Practice address
3624 J DEWEY GRAY CIR, SUITE 250, AUGUSTA, GA 30909-6667
(706) 855-9565
Mailing address
3624 J DEWEY GRAY CIR, SUITE 250, AUGUSTA, GA 30909-6667
(706) 855-9565
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000713402C
—
GA
Enumeration date
03/02/2006
Last updated
11/02/2011
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