Provider Demographics
NPI:1649228404
Name:RJPUDER, LLC
Entity Type:Organization
Organization Name:RJPUDER, LLC
Other - Org Name:ATHENS ASSOCIATES IN FAMILY PRACTICE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE AND BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRYSTIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:706-353-7648
Mailing Address - Street 1:300 HAWTHORNE LN
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2152
Mailing Address - Country:US
Mailing Address - Phone:706-353-7648
Mailing Address - Fax:706-353-7788
Practice Address - Street 1:300 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2152
Practice Address - Country:US
Practice Address - Phone:706-353-7648
Practice Address - Fax:706-353-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty