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General NPI Number Information
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NPI Number | 1912009085
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Entity Type | Organization
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Legal Business Name | ATHENS AREA FAMILY MEDICINE ASSOCIATES PC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1351 STONEBRIDGE PKWY BUILDING 104
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City | WATKINSVILLE
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State | GA
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Zip | 30677-6037
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Country | US
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Telephone | 706-769-4141
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Fax | 706-769-4116
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Provider Business Mailing Address
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Address Line | 1351 STONEBRIDGE PKWY BUILDING 104
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City | WATKINSVILLE
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State | GA
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Zip | 30677-6037
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Country | US
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Telephone | 706-769-4141
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Fax | 706-769-4116
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | CATHLEEN QUILLIAN-CARR
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Credential | D.O.
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Telephone | 706-769-4141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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