Provider Demographics
NPI:1912009085
Name:ATHENS AREA FAMILY MEDICINE ASSOCIATES PC
Entity Type:Organization
Organization Name:ATHENS AREA FAMILY MEDICINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUILLIAN-CARR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:706-769-4141
Mailing Address - Street 1:1351 STONEBRIDGE PKWY
Mailing Address - Street 2:BUILDING 104
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-6037
Mailing Address - Country:US
Mailing Address - Phone:706-769-4141
Mailing Address - Fax:706-769-4116
Practice Address - Street 1:1351 STONEBRIDGE PKWY
Practice Address - Street 2:BUILDING 104
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-6037
Practice Address - Country:US
Practice Address - Phone:706-769-4141
Practice Address - Fax:706-769-4116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty