Provider Demographics
NPI:1841250925
Name:AHRENS, ROBERT K (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:AHRENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1009
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-0022
Mailing Address - Country:US
Mailing Address - Phone:706-769-3331
Mailing Address - Fax:706-769-3360
Practice Address - Street 1:1351 STONEBRIDGE PKWY
Practice Address - Street 2:BLDG 105
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-6037
Practice Address - Country:US
Practice Address - Phone:706-769-3331
Practice Address - Fax:706-769-3360
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00837999AMedicaid
GA00837999AMedicaid
A57176Medicare UPIN