Provider Demographics
NPI:1164926739
Name:ATHENS HEART CENTER, PC
Entity Type:Organization
Organization Name:ATHENS HEART CENTER, PC
Other - Org Name:AHC SPECIALTY CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SUBODH
Authorized Official - Middle Name:K
Authorized Official - Last Name:AGRAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-208-8258
Mailing Address - Street 1:2005 PRINCE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6032
Mailing Address - Country:US
Mailing Address - Phone:706-356-8181
Mailing Address - Fax:
Practice Address - Street 1:1999 PRINCE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6013
Practice Address - Country:US
Practice Address - Phone:706-356-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATHENS HEART CENTER, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-20
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty