Provider Demographics
NPI:1730495680
Name:ATHENS OBGYN II LLC
Entity type:Organization
Organization Name:ATHENS OBGYN II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-943-0205
Mailing Address - Street 1:5909 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-8102
Mailing Address - Country:US
Mailing Address - Phone:404-943-0205
Mailing Address - Fax:404-943-0209
Practice Address - Street 1:740 PRINCE AVE
Practice Address - Street 2:BLDG 3
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5908
Practice Address - Country:US
Practice Address - Phone:706-548-4272
Practice Address - Fax:706-548-9181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty