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Organization
PATHOLOGY AND LABORATORY CONSULTANTS OF ATHENS LLC
Active
Organization
PATHOLOGY AND LABORATORY CONSULTANTS OF ATHENS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH J GAINES JR. MD (PRES)
(706) 389-2425
Entity
Organization
Contact information
Practice address
1230 BAXTER ST, ATHENS, GA 30606
(706) 389-2425
(770) 389-2426
Mailing address
PO BOX 491270, LAWRENCEVILLE, GA 30049
(770) 237-4500
(770) 237-4539
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN8205
RAILROAD MEDICARE
GA
Enumeration date
03/10/2006
Last updated
02/22/2008
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