Organization
PRIMEDOC OF ATHENS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT REYNOLDS MD (PRESIDENT)
(843) 237-3378
Entity
Organization
Contact information
Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 601153, CHARLOTTE, NC 28260-1153
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
695069922A
—
GA
01
—
DC0899
RAILROAD MEDICARE
GA
Enumeration date
04/25/2006
Last updated
03/16/2009
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