Organization
UNIVERSITY ANESTHESIOLOGY ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CULLER (OFFICE MANAGER)
(706) 737-9250
Entity
Organization
Contact information
Practice address
1350 WALTON WAY, AUGUSTA, GA 30901-2612
(706) 737-9250
(706) 733-0697
Mailing address
1824 WALTON WAY, AUGUSTA, GA 30904-3804
(706) 737-9250
(706) 733-0697
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC5172
RAILROAD MEDICARE
GA
05
—
GPA617
—
SC
Enumeration date
06/01/2006
Last updated
04/15/2008
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