Healthcare Provider Details

I. General information

NPI: 1932065372
Provider Name (Legal Business Name): AVENUE SURGICAL PARTNERS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 N MILLEDGE AVE STE A
ATHENS GA
30601-3807
US

IV. Provider business mailing address

489 N MILLEDGE AVE STE A
ATHENS GA
30601-3807
US

V. Phone/Fax

Practice location:
  • Phone: 706-363-0256
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHELSEA VENDITTO
Title or Position: MD/OWNER
Credential: MD
Phone: 706-363-0256