Healthcare Provider Details

I. General information

NPI: 1467583203
Provider Name (Legal Business Name): ATHENS MEDICAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 HOSPITAL DR STE 260
ATHENS OH
45701-2857
US

IV. Provider business mailing address

510 W UNION ST STE A
ATHENS OH
45701-2331
US

V. Phone/Fax

Practice location:
  • Phone: 740-594-8819
  • Fax:
Mailing address:
  • Phone: 740-594-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNP09347
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNM09326
License Number StateOH

VIII. Authorized Official

Name: MEGAN E BAER
Title or Position: CREDENTIALING
Credential:
Phone: 740-594-7979