Organization
KMC SURGICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STARLA STALLINGS (PRACTICE MANAGER)
(706) 737-7922
Entity
Organization
Contact information
Practice address
2320 WRIGHTSBORO RD, AUGUSTA, GA 30904-6233
(706) 737-7922
(706) 737-7968
Mailing address
2320 WRIGHTSBORO RD, AUGUSTA, GA 30904-6233
(706) 737-7922
(706) 737-7968
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
53781
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
585070845A
—
GA
Enumeration date
10/24/2014
Last updated
10/24/2014
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