Provider Demographics
NPI:1083763080
Name:ATHENS REGIONAL PHYSICIAN SERVICES, INC.
Entity Type:Organization
Organization Name:ATHENS REGIONAL PHYSICIAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC DIR REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-369-5472
Mailing Address - Street 1:PO BOX 161463
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30321
Mailing Address - Country:US
Mailing Address - Phone:706-369-5440
Mailing Address - Fax:706-369-5490
Practice Address - Street 1:1500 OGLETHORPE AVENUE, SUITE 600A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-369-5440
Practice Address - Fax:706-369-5490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP5135OtherMEDICARE GROUP NUMBER