Organization
ATHENS BONE AND JOINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY J GREGORY (CREDENTIALING)
(706) 395-1673
Entity
Organization
Contact information
Practice address
33 CHESTNUT ST, ELBERTON, GA 30635-1833
(706) 583-9000
Mailing address
1010 PRINCE AVE, SUITE 115 SOUTH, ATHENS, GA 30606-5805
(706) 583-9000
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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