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Organization

PIEDMONT ATHENS SPECIALTY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHRISTY AQUINO (DIRECTOR OF PROVIDER ENROLLMENT)
(470) 271-3427
Entity
Organization

Contact information

Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 475-7000
Mailing address
PO BOX 117265, ATLANTA, GA 30368-7264
(706) 475-7000

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207V00000X
Obstetrics & Gynecology Physician
208600000X
Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003208695A
GA
Enumeration date
12/20/2017
Last updated
08/11/2021
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