Organization
ENT OF ATHENS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS (BILLING MANAGER)
(706) 546-7908
Entity
Organization
Contact information
Practice address
150 NACOOCHEE AVE, ATHENS, GA 30601-1823
(706) 546-7908
(706) 546-1944
Mailing address
150 NACOOCHEE AVE, ATHENS, GA 30601-1823
(706) 546-7908
(706) 546-1944
Taxonomy
Speciality
Code
Description
License number
State
207YS0012X
Sleep Medicine (Otolaryngology) Physician
Primary
052997
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
446447978B
—
GA
Enumeration date
09/29/2009
Last updated
06/07/2021
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