Provider Demographics
NPI:1114331881
Name:AVID COMPANIES
Entity Type:Organization
Organization Name:AVID COMPANIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-956-1006
Mailing Address - Street 1:1655 LEBANON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5116
Mailing Address - Country:US
Mailing Address - Phone:678-956-1006
Mailing Address - Fax:
Practice Address - Street 1:1655 LEBANON RD
Practice Address - Street 2:SUITE C
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5116
Practice Address - Country:US
Practice Address - Phone:678-956-1006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2013010994OtherNPI