Organization
ATHENS-CLARKE EMERGENCY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL DAVIS (OFFICE MANAGER)
(706) 543-3449
Entity
Organization
Contact information
Practice address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 543-3449
(706) 543-5744
Mailing address
PO BOX 48298, ATHENS, GA 30604-8298
(706) 543-3449
(706) 543-5744
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG3792
RAILROAD MEDICARE
GA
Enumeration date
05/31/2006
Last updated
11/15/2007
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