Provider Demographics
NPI:1750993531
Name:DOCTOR ATHEY
Entity type:Organization
Organization Name:DOCTOR ATHEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:ATHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-268-6992
Mailing Address - Street 1:4760 FLINTRIDGE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4264
Mailing Address - Country:US
Mailing Address - Phone:719-268-6992
Mailing Address - Fax:719-570-0386
Practice Address - Street 1:4760 FLINTRIDGE DR STE 250
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4264
Practice Address - Country:US
Practice Address - Phone:719-268-6992
Practice Address - Fax:719-570-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty