Provider Demographics
NPI:1720239551
Name:ATHENS REGIONAL PHYSICIAN SERVICES, INC
Entity Type:Organization
Organization Name:ATHENS REGIONAL PHYSICIAN SERVICES, INC
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 1:1500 OGLETHORPE AVE
Mailing Address - Street 2:SUITE 600A
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2179
Mailing Address - Country:US
Mailing Address - Phone:706-475-4920
Mailing Address - Fax:
Practice Address - Street 1:1618 MARS HILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4847
Practice Address - Country:US
Practice Address - Phone:706-769-2053
Practice Address - Fax:706-769-9731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty