Individual
REBECCA JEAN ATHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1350 WALTON WAY, AUGUSTA, GA 30901-2612
(706) 737-9250
(706) 733-0697
Mailing address
1824 WALTON WAY, AUGUSTA, GA 30904-3804
(706) 737-9250
(706) 733-0697
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
038170
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
038170
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000635643C
—
GA
01
—
050045869
RAILROAD MEDICARE
GA
05
—
G38170
—
SC
Enumeration date
05/16/2006
Last updated
06/16/2008
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