Organization
COGA HEALTH
Active
Other names
Coastal Georgia Child Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
MAYNARD ASHLEY HUTSON (OWNER/MANAGER)
(864) 884-1137
Entity
Organization
Contact information
Practice address
139 ALTAMA CONNECTOR, PMB 316, BRUNSWICK, GA 31525-1888
(864) 884-1137
(912) 330-1009
Mailing address
139 ALTAMA CONNECTOR, PMB 316, BRUNSWICK, GA 31525-1888
(864) 884-1137
(912) 330-1009
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
75523
GA
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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