Organization Name: | GEORGIA REGENTS UNIVERSITY |
NPI Number: | 1386065258 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAD ALLEN ASPLUND (MEDICAL DIRECTOR STUDENT HEALTH) |
Mailing Address: | 1120 15th St Pavilion Ii, Af 1040 Augusta |
State: | GA US |
Postal Code: | 309120004 |
Phone Number: | 7067234302 |
Fax Number: | |
NPI Enumeration Date: | 12/19/2013 |
NPI Last Update Date: | 12/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 58438 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |