Provider Demographics
NPI:1235603176
Name:INTEGRATED MEDICINE OF ATHENS, LLC
Entity Type:Organization
Organization Name:INTEGRATED MEDICINE OF ATHENS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GROFT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-227-3292
Mailing Address - Street 1:623 N MILLEDGE AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-3803
Mailing Address - Country:US
Mailing Address - Phone:706-227-3292
Mailing Address - Fax:888-809-9345
Practice Address - Street 1:623 N MILLEDGE AVE UNIT A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-3803
Practice Address - Country:US
Practice Address - Phone:706-227-3292
Practice Address - Fax:888-809-9345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty