Basic Information
| Provider Information | |||||||||
| NPI: | 1134350531 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMSOL PHYSICIANS OF GEORGIA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 63 | ||||||||
| Address2: | |||||||||
| City: | LANDISVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175380063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008001617 | ||||||||
| FaxNumber: | 8667595426 | ||||||||
| Practice Location | |||||||||
| Address1: | 710 CENTER ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319011527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065711000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2009 | ||||||||
| LastUpdateDate: | 08/03/2009 | ||||||||
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| AuthorizedOfficialLastName: | HILLIARD | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
| AuthorizedOfficialMiddleName: | DALE | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 3368991400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.