Provider Demographics
NPI:1295904050
Name:AUGUSTIN, JOSEPH CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:AUGUSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9234
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30916
Mailing Address - Country:US
Mailing Address - Phone:504-975-5274
Mailing Address - Fax:
Practice Address - Street 1:1355 INDEPENDENCE DR
Practice Address - Street 2:PHYSICIAN SUITE
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-1037
Practice Address - Country:US
Practice Address - Phone:706-722-1244
Practice Address - Fax:706-722-6566
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA650822081P2900X
LA2008642081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine