Healthcare Provider Details

I. General information

NPI: 1629097738
Provider Name (Legal Business Name): ATHENS PHYSICIANS PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 COOK DR SUITE 100
ATHENS TN
37303-3486
US

IV. Provider business mailing address

711 COOK DR STE 100
ATHENS TN
37303-3499
US

V. Phone/Fax

Practice location:
  • Phone: 423-744-7585
  • Fax: 423-744-7075
Mailing address:
  • Phone: 423-744-7585
  • Fax: 423-744-7075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000