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General NPI Number Information
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NPI Number | 1639128143
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Entity Type | Organization
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Legal Business Name | GREATER ATHENS PHYSICIANS, INC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 1550 MARS HILL RD
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City | WATKINSVILLE
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State | GA
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Zip | 30677-4836
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Country | US
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Telephone | 706-769-6469
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Fax | 706-769-4402
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Provider Business Mailing Address
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Address Line | 1550 MARS HILL RD PO BOX 409
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City | WATKINSVILLE
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State | GA
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Zip | 30677-4836
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Country | US
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Telephone | 706-769-6469
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Fax | 706-769-4402
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JAN WALKER LEE
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Credential |
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Telephone | 706-769-6469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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