Organization
ATHEN KIDS SPECIALISTS P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPHINE T. LOPEZ MD (OWNER)
(706) 543-9899
Entity
Organization
Contact information
Practice address
650 OGLETHORPE AVE., STE 4, ATHENS, GA 30303-2216
(706) 543-9899
(956) 283-1889
Mailing address
650 OGLETHORPE AVE., STE 4, ATHENS, GA 30303-2216
(706) 543-9899
(956) 283-1889
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10056366
AMERIGROUP
GA
01
—
197380
BC BS OF GA
GA
01
—
341305
WELLCARE
GA
01
—
8668423278
UNITED HEALTH CARE
GA
Enumeration date
12/18/2006
Last updated
08/22/2020
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