Provider Demographics
NPI:1659522167
Name:ATHENS REGIONAL PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:ATHENS REGIONAL PHYSICIAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-475-4920
Mailing Address - Street 1:700 OGLETHORPE AVE
Mailing Address - Street 2:STE 6B
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2221
Mailing Address - Country:US
Mailing Address - Phone:706-548-3196
Mailing Address - Fax:706-546-6772
Practice Address - Street 1:700 OGLETHORPE AVE
Practice Address - Street 2:SUITE 6B
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2221
Practice Address - Country:US
Practice Address - Phone:706-548-3196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty