Organization
ATHENS ORTHOPEDIC AND PHYSICAL THERAPY CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN LEE FAIN MD (PRESIDENT)
(903) 675-9526
Entity
Organization
Contact information
Practice address
1123 S PALESTINE ST, ATHENS, TX 75751-3646
(903) 675-9526
(903) 677-1815
Mailing address
1123 S PALESTINE ST, ATHENS, TX 75751-3646
(903) 675-9526
(903) 677-1815
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00917N
BLUE CROSS BLUE SHIELD
TX
05
—
081361001
—
TX
Enumeration date
10/13/2005
Last updated
02/02/2010
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