PRINCE AVENUE PRIMARY CARE L.L.C. NPI 1386676211

NPI Information

PRINCE AVENUE PRIMARY CARE, L.L.C. is a family medicine in Athens, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PRINCE AVENUE PRIMARY CARE, L.L.C. NPI is 1386676211. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

892 PRINCE AVE
ATHENS, GA
ZIP 30606-724
Phone: (706) 227-2027
Fax: (706) 227-2433

The provider's authorized official is Timothy B Gibson .
The authorized official title is Ceo and has the following contact phone number (706) 227-2027.

The CLIA number assigned to this NPI record is 11D0946237 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 12/28/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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