Organization
MEDICAL COLLEGE OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STYLES L BERTRAND M.D. (CHIEF, PEDIATRIC ORTHOPAEDICS)
(706) 721-2849
Entity
Organization
Contact information
Practice address
1120 15TH ST, BP-2109, AUGUSTA, GA 30912-0004
(706) 721-2849
Mailing address
1120 15TH ST, BP-2109, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
025718
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00312485A
—
GA
05
—
G25718
—
SC
Enumeration date
10/18/2006
Last updated
08/22/2020
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