Organization
CONTRACT PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JULIE DEASON (DIRECTOR)
(706) 774-8326
Entity
Organization
Contact information
Practice address
1350 WALTON WAY, AUGUSTA, GA 30901-2612
(706) 774-7365
(706) 828-2389
Mailing address
PO BOX 31258, AUGUSTA, GA 30903-3058
(706) 828-2374
(706) 828-2389
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
—
GA
207X00000X
Orthopaedic Surgery Physician
Primary
—
GA
363L00000X
Nurse Practitioner
—
GA
Other
Enumeration date
11/02/2006
Last updated
08/14/2012
Update your record
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