| Augusta Specialty Hospitalists Llc | |
|
3623 J Dewey Gray Cir Suite 113 Augusta GA 30909-6511 | |
| (706) 855-0422 | |
| (706) 855-0495 |
| Full Name | Augusta Specialty Hospitalists Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3623 J Dewey Gray Cir, Augusta, Georgia |
| Authorized Official Name and Position | Robert Faile (VICE PRESIDENT) |
| Authorized Official Contact | 8438567923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Augusta Specialty Hospitalists Llc 2000 Health Park Dr Brentwood TN 37027-4692 Ph: (615) 373-7406 | Augusta Specialty Hospitalists Llc 3623 J Dewey Gray Cir Suite 113 Augusta GA 30909-6511 Ph: (706) 855-0422 |
| NPI Number | 1164711297 |
|---|---|
| Provider Enumeration Date | 03/29/2011 |
| Last Update Date | 01/11/2024 |
| Certification Date | 12/11/2023 |
| Medicare PECOS PAC ID | 5496931842 |
|---|---|
| Medicare Enrollment ID | O20110519000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164711297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Dichen Zhao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336178565 PECOS PAC ID: 2466483557 Enrollment ID: I20050829000607 |
| Provider Name | Krishan M Khera |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1912141094 PECOS PAC ID: 5294977872 Enrollment ID: I20140630001204 |
| Provider Name | John Edry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952697971 PECOS PAC ID: 4385883438 Enrollment ID: I20151026000161 |
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