Provider Demographics
NPI:1942833827
Name:AXIS RISK LLC
Entity Type:Organization
Organization Name:AXIS RISK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:678-660-3366
Mailing Address - Street 1:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:SOCIAL CIRCLE
Mailing Address - State:GA
Mailing Address - Zip Code:30025
Mailing Address - Country:US
Mailing Address - Phone:770-464-1818
Mailing Address - Fax:678-202-5069
Practice Address - Street 1:6142 GORDY STREET
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014
Practice Address - Country:US
Practice Address - Phone:678-660-3366
Practice Address - Fax:678-202-5069
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AXIS RISK SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty