Healthcare Provider Details

I. General information

NPI: 1821346073
Provider Name (Legal Business Name): REDDY URGENT CARE-HARTWELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2012
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 E FRANKLIN ST
HARTWELL GA
30643-7301
US

IV. Provider business mailing address

1061 DOWDY RD STE 101
ATHENS GA
30606-5700
US

V. Phone/Fax

Practice location:
  • Phone: 706-621-7575
  • Fax: 706-621-7557
Mailing address:
  • Phone: 706-621-7575
  • Fax: 706-621-7557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24178
License Number StateGA

VIII. Authorized Official

Name: MRS. RAM REDDY
Title or Position: CEO
Credential: MD
Phone: 706-621-7575