Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
May 2, 2022
License(s)
103433 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1350 WALTON WAY | Augusta, GA 30901-2612 | 706-774-5795 |
| LOCATION | 1350 WALTON WAY | Augusta, GA 30901-2612 | 706-774-5795 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.