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Organization
BOULEVARD FAMILY PRACTICE
Active
Organization
BOULEVARD FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS WEINER MBBS (PHYSICIAN)
(706) 850-6134
Entity
Organization
Contact information
Practice address
1010 PRINCE AVE STE 184, ATHENS, GA 30606-5815
(706) 850-6134
Mailing address
1010 PRINCE AVE STE 184, ATHENS, GA 30606-5815
(706) 850-6134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
72811
GA
207Q00000X
Family Medicine Physician
Primary
72846
GA
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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