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ATHENS GYNECOLOGY PC NPI 1215132527


NPI Information

NPI: 1215132527
Provider Name: ATHENS GYNECOLOGY PC

Doing Business As: EASTSIDE GYNECOLOGY

Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

CLIA Number: 11D2102288

Address:
1270 PRINCE AVENUE
SUITE 202
ATHENS, GA
ZIP 30606
Phone: (706) 548-4424
Get Directions

ATHENS GYNECOLOGY PC is a gynecology obstetrics gynecology in Athens, GA. ATHENS GYNECOLOGY PC NPI is 1215132527. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Eastside Gynecology.

The provider's business location address is:

1270 PRINCE AVENUE
SUITE 202
ATHENS, GA
ZIP 30606
Phone: (706) 548-4424
Fax: (706) 548-4880

The provider's authorized official is Robert Earl Kelley .
The authorized official title is Physician President and has the following contact phone number (706) 548-4424.

The CLIA number assigned to this NPI record is 11D2102288 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/18/2007 and was last updated on 4/24/2008.


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
1207VG0400XObstetrics & GynecologyGynecologyYes

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
1D40334MEDICARE UPIN
2GRP6568MEDICARE ID-TYPE UNSPECIFIEDGEORGIA
3000084763BMEDICAIDGEORGIA

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

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