Provider Demographics
NPI:1376240358
Name:AU MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:AU MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-721-5505
Mailing Address - Street 1:1120 15TH STREET
Mailing Address - Street 2:OR6000
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912
Mailing Address - Country:US
Mailing Address - Phone:706-721-5505
Mailing Address - Fax:
Practice Address - Street 1:1417 PENDLETON RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4837
Practice Address - Country:US
Practice Address - Phone:706-738-9824
Practice Address - Fax:706-731-9918
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AU MEDICAL ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty