Organization
OCONEE ENT AND COSMETIC SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANA WOOD (MANAGER)
(478) 452-4800
Entity
Organization
Contact information
Practice address
850 W THOMAS ST, MILLEDGEVILLE, GA 31061-2674
(478) 452-4800
Mailing address
850 W THOMAS ST, MILLEDGEVILLE, GA 31061-2674
(478) 452-4800
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00813799A
—
GA
01
—
511G040002
MEDICARE PTAN
GA
Enumeration date
10/28/2008
Last updated
04/28/2009
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