Provider Demographics
NPI:1184771313
Name:ATHENS HEALTHCARE FOR WOMEN PC
Entity type:Organization
Organization Name:ATHENS HEALTHCARE FOR WOMEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEPESI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-552-1600
Mailing Address - Street 1:1270 PRINCE AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2762
Mailing Address - Country:US
Mailing Address - Phone:706-552-1600
Mailing Address - Fax:706-552-5370
Practice Address - Street 1:1270 PRINCE AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2762
Practice Address - Country:US
Practice Address - Phone:706-552-1600
Practice Address - Fax:706-552-5370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051738207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA963216OtherBLUE CROSS BLUE SHIELD
GA322075OtherWELLCARE
GA10059222OtherAMERIGROUP
GA16BBCWWMedicare ID - Type Unspecified
GA322075OtherWELLCARE