Individual
TANYA MOGUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0006
(706) 721-3157
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0006
(706) 721-3157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17126
GA
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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