Provider Demographics
NPI:1396332847
Name:OCONEE PROSTHETICS LLC
Entity type:Organization
Organization Name:OCONEE PROSTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:LCP
Authorized Official - Phone:706-850-3883
Mailing Address - Street 1:PO BOX 1714
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-0034
Mailing Address - Country:US
Mailing Address - Phone:706-850-3883
Mailing Address - Fax:
Practice Address - Street 1:1050 BARBER CREEK DR STE 103
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4502
Practice Address - Country:US
Practice Address - Phone:706-850-3883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty