Organization
AUGUSTA UROLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANISSA COOPER (ADMINISTRATOR)
(706) 722-0705
Entity
Organization
Contact information
Practice address
4350 TOWNE CENTRE DR STE 2200, EVANS, GA 30809-3346
(706) 722-0705
(706) 993-1284
Mailing address
4350 TOWNE CENTRE DR STE 2200, EVANS, GA 30809-3346
(706) 722-0705
(706) 312-3026
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300033214G
—
GA
Enumeration date
11/07/2006
Last updated
04/04/2025
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