Provider Type Icon

ATHENS DIABETES AND ENDOCRINOLOGY NPI 1487865952


NPI Information

NPI: 1487865952
Provider Name: ATHENS DIABETES AND ENDOCRINOLOGY
Classification: Internal Medicine - 207RE0101X
Entity Type: Organization

Specialization: Endocrinology, Diabetes & Metabolism

CLIA Number: 11D0261927

Address:
3320 OLD JEFFERSON RD STE 600
ATHENS, GA
ZIP 30607
Phone: (706) 549-4155
Get Directions

ATHENS DIABETES AND ENDOCRINOLOGY is an endocrinology and diabetes and metabolism internal medicine in Athens, GA. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. ATHENS DIABETES AND ENDOCRINOLOGY NPI is 1487865952. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3320 OLD JEFFERSON RD STE 600
ATHENS, GA
ZIP 30607-463
Phone: (706) 549-4155
Fax: (706) 546-0036

The provider's authorized official is Peter Frandsen Vandyck .
The authorized official title is Owner and has the following contact phone number (706) 549-4155.

The CLIA number assigned to this NPI record is 11D0261927 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2007 and was last updated on 12/15/2009.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RE0101XInternal MedicineEndocrinology, Diabetes & Metabolism27679GEORGIAYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E19942MEDICARE UPINGEORGIA
211BDBKLMEDICARE ID-TYPE UNSPECIFIED
30384997BMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.