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Organization

ATHENS BONE AND JOINT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY JUDITH GREGORY (CREDENTIALING)
(706) 395-1673
Entity
Organization

Contact information

Practice address
528 PANTHER DR, JEFFERSON, GA 30549-5400
(706) 583-9000
Mailing address
1010 PRINCE AVE, SUITE 115 SOUTH, ATHENS, GA 30606-5805
(706) 395-1673

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GRP7521
MEDICARE PTAN
GA
Enumeration date
05/02/2016
Last updated
05/02/2016
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