Organization
ATHENS SURGICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA NIX (OFFICE MANAGER)
(706) 353-1630
Entity
Organization
Contact information
Practice address
740 PRINCE AVE BLDG 8A, ATHENS, GA 30606-5903
(706) 353-1630
(706) 543-6825
Mailing address
740 PRINCE AVE BLDG 8A, ATHENS, GA 30606-5903
(706) 353-1630
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
019390
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP4622
MEDICARE GROUP NUMBER
GA
Enumeration date
06/27/2007
Last updated
03/08/2010
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