Healthcare Provider Details

I. General information

NPI: 1427184654
Provider Name (Legal Business Name): REDDY MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 W BROAD ST STE A
ATHENS GA
30601-2511
US

IV. Provider business mailing address

1061 DOWDY RD STE 204
ATHENS GA
30606-5700
US

V. Phone/Fax

Practice location:
  • Phone: 706-621-7575
  • Fax: 833-305-0340
Mailing address:
  • Phone: 706-621-7575
  • Fax: 833-305-0340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHERRI LYNN CRAFT
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 706-246-9713