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Organization

WRIGHTSBORO EMERGENCY GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(800) 893-9698
Entity
Organization

Contact information

Practice address
2260 WRIGHTSBORO RD, AUGUSTA, GA 30904-4764
(800) 893-9698
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
GA
363A00000X
Physician Assistant
GA
363L00000X
Nurse Practitioner
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003161266A
GA
Enumeration date
05/21/2015
Last updated
07/11/2017
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