Healthcare Provider Details

I. General information

NPI: 1326208893
Provider Name (Legal Business Name): J. EDWARD DEMPSEY, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 03/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 NACOOCHEE AVE
ATHENS GA
30601-1823
US

IV. Provider business mailing address

150 NACOOCHEE AVE
ATHENS GA
30601-1823
US

V. Phone/Fax

Practice location:
  • Phone: 706-546-7908
  • Fax: 706-546-1944
Mailing address:
  • Phone: 706-546-7908
  • Fax: 706-546-1944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number10908
License Number StateGA

VIII. Authorized Official

Name: MRS. AMY T. ELLIS
Title or Position: INSURANCE CLERK
Credential:
Phone: 706-546-7908