Provider Demographics
NPI:1801337779
Name:WOMEN'S HEALTH OF AUGUSTA
Entity type:Organization
Organization Name:WOMEN'S HEALTH OF AUGUSTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THIGPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-733-4427
Mailing Address - Street 1:1303 DANTIGNAC ST STE 2500
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2792
Mailing Address - Country:US
Mailing Address - Phone:706-733-4427
Mailing Address - Fax:706-737-0215
Practice Address - Street 1:1303 DANTIGNAC ST STE 2500
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2792
Practice Address - Country:US
Practice Address - Phone:706-733-4427
Practice Address - Fax:706-737-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003316363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty