Organization
PIEDMONT ATHENS SPECIALTY CARE LLC
Active
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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