Provider Demographics
NPI:1033141882
Name:AUGUSTA ARTHRITIS CENTER INC
Entity Type:Organization
Organization Name:AUGUSTA ARTHRITIS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SHAFTER
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-828-0043
Mailing Address - Street 1:811 13TH ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2700
Mailing Address - Country:US
Mailing Address - Phone:702-828-0043
Mailing Address - Fax:706-828-0450
Practice Address - Street 1:811 13TH ST
Practice Address - Street 2:SUITE 14
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2700
Practice Address - Country:US
Practice Address - Phone:702-828-0043
Practice Address - Fax:706-828-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA28541174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH55008Medicare UPIN
GAGRP3909Medicare ID - Type Unspecified
GAD30083Medicare UPIN
GAD39846Medicare UPIN