Provider Demographics
NPI:1477208346
Name:AUGUSTA RETINA CONSULTANTS
Entity Type:Organization
Organization Name:AUGUSTA RETINA CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-426-7342
Mailing Address - Street 1:1701 MAGNOLIA WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-9485
Mailing Address - Country:US
Mailing Address - Phone:706-589-5361
Mailing Address - Fax:888-383-7386
Practice Address - Street 1:111 GREGG AVE NW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-2797
Practice Address - Country:US
Practice Address - Phone:706-426-7342
Practice Address - Fax:888-383-7386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery