Organization
AUGUSTA INPATIENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LAVERTY (VP)
(615) 373-7600
Entity
Organization
Contact information
Practice address
3623 J DEWEY GRAY CIR, SUITE 113, AUGUSTA, GA 30909-6511
(706) 855-0422
(706) 855-0495
Mailing address
3623 J DEWEY GRAY CIR, SUITE 113, AUGUSTA, GA 30909-6511
(706) 855-0422
(706) 855-0495
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
672340027A
—
GA
01
—
DF7769
RR MEDICARE
GA
Enumeration date
02/25/2009
Last updated
05/07/2010
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