Organization
ATHENS SPINE WELLNESS CENTER LLC
Active
Parent organization
ATHENS SPINE CENTER PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATHENS SPINE CENTER PC
Authorized official
WILLIAM MEGDAL M.D. (PRESIDENT)
(706) 425-2400
Entity
Organization
Contact information
Practice address
830 KING AVE, ATHENS, GA 30606-2889
(706) 425-2400
(706) 425-2410
Mailing address
830 KING AVE, ATHENS, GA 30606-2889
(706) 425-2400
(706) 425-2410
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
152
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000275646B
—
GA
05
—
373133496A
—
GA
05
—
537122616A
—
GA
Enumeration date
11/06/2013
Last updated
11/06/2013
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