Healthcare Provider Details

I. General information

NPI: 1922993500
Provider Name (Legal Business Name): GOWDIE FAMILY CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 OGLETHORPE AVE STE 3500
ATHENS GA
30606-2191
US

IV. Provider business mailing address

1500 OGLETHORPE AVE STE 3500
ATHENS GA
30606-2191
US

V. Phone/Fax

Practice location:
  • Phone: 706-410-2684
  • Fax: 706-413-1746
Mailing address:
  • Phone: 706-410-2684
  • Fax: 706-413-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STALINA GOWDIE
Title or Position: CEO
Credential: MD
Phone: 706-410-2684