Organization
RENUE SURGERY CENTER OF WAYCROSS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WILLIAM MITCHELL M.D. (MANAGER)
(912) 280-9977
Entity
Organization
Contact information
Practice address
1905 TEBEAU ST, WAYCROSS, GA 31501-6356
(912) 280-9977
(912) 280-9995
Mailing address
PO BOX 2198, BRUNSWICK, GA 31521-2198
(912) 280-9977
(912) 280-9995
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/18/2011
Last updated
10/28/2020
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