Provider Demographics
NPI:1275714438
Name:O AKHRAS MD PC
Entity Type:Organization
Organization Name:O AKHRAS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHRAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-444-6521
Mailing Address - Street 1:120 SPARTA HIGHWAY
Mailing Address - Street 2:P O BOX 3280
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024
Mailing Address - Country:US
Mailing Address - Phone:706-485-4002
Mailing Address - Fax:706-485-7117
Practice Address - Street 1:120 SPARTA HWY
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024
Practice Address - Country:US
Practice Address - Phone:706-485-4002
Practice Address - Fax:706-485-7117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD28767Medicare UPIN
GA113863Medicare Oscar/Certification