Provider Demographics
NPI:1861500183
Name:UNIVERSITY SURGICAL ASSOCIATES OF ATHENS
Entity Type:Organization
Organization Name:UNIVERSITY SURGICAL ASSOCIATES OF ATHENS
Other - Org Name:UNIVERSITY VASCULAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOODY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-549-8306
Mailing Address - Street 1:1357 OCONEE CONNECTOR
Mailing Address - Street 2:BUILDING 300
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677
Mailing Address - Country:US
Mailing Address - Phone:706-549-8306
Mailing Address - Fax:706-549-4099
Practice Address - Street 1:1357 OCONEE CONNECTOR BLDG 300
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7314
Practice Address - Country:US
Practice Address - Phone:706-549-8306
Practice Address - Fax:706-549-8351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-27
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty