Provider Demographics
NPI:1518452150
Name:ATHENS AREA PEDIATRICS LLC
Entity Type:Organization
Organization Name:ATHENS AREA PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ATHENS AREA PEDIATRICS LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SETIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-613-6136
Mailing Address - Street 1:225 HAWTHORNE PARK
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2151
Mailing Address - Country:US
Mailing Address - Phone:706-613-6136
Mailing Address - Fax:706-543-0706
Practice Address - Street 1:225 HAWTHORNE PARK
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2151
Practice Address - Country:US
Practice Address - Phone:706-613-6136
Practice Address - Fax:706-543-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037368261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care