Provider Demographics
NPI:1003952193
Name:AUGUSTA HYPERTENTION, P.C.
Entity Type:Organization
Organization Name:AUGUSTA HYPERTENTION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:H
Authorized Official - Last Name:KAESEMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-722-4688
Mailing Address - Street 1:PO BOX 3545
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-3545
Mailing Address - Country:US
Mailing Address - Phone:706-868-0131
Mailing Address - Fax:706-854-0131
Practice Address - Street 1:1021 15TH ST STE 2
Practice Address - Street 2:BIO TECH PARK
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-3112
Practice Address - Country:US
Practice Address - Phone:706-722-4688
Practice Address - Fax:706-722-8194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00224331GMedicaid