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General NPI Number Information
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NPI Number | 1679945596
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Entity Type | Organization
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Legal Business Name | ATHENS CARDIAC CLINIC PC
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 1360 CADUCEUS WAY BUILDING 600 SUITE 105
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City | WATKINSVILLE
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State | GA
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Zip | 30677-7300
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Country | US
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Telephone | 470-240-2224
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 EPPS BRIDGE PKWY SUITE 108 #136
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City | ATHENS
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State | GA
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Zip | 30606-6132
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | ROHIT TONGIA
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Credential |
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Telephone | 770-868-6254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 056494
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 056494
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License Number State | GA
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