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Individual

ALLISON SUPERNEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-4330
(706) 721-8623
Mailing address
1120 15TH ST # OR2029, AUGUSTA, GA 30912-0004
(706) 721-8623

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
UO4614
FL
2086S0127X
Trauma Surgery Physician
009465
AZ
2086S0127X
Trauma Surgery Physician
Primary
97242
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
08/11/2015
Last updated
02/20/2026
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