Organization
AUGUSTA DEVELOPMENTAL SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY VERNELL DONALDSON (OFFICE MANAGER)
(706) 396-0604
Entity
Organization
Contact information
Practice address
1303 D'ANTIGNAC STREET, SUITE 2100, AUGUSTA, GA 30901
(706) 396-0600
(706) 396-0606
Mailing address
1303 D'ANTIGNAC STREET, SUITE 2100, AUGUSTA, GA 30901
(706) 396-0600
(706) 396-0606
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
044184
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003115063A
—
GA
Enumeration date
07/29/2011
Last updated
02/13/2015
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