Provider Demographics
NPI:1861426520
Name:ATHENS CARDIOLOGY GROUP
Entity type:Organization
Organization Name:ATHENS CARDIOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-546-8510
Mailing Address - Street 1:700 OGLETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2221
Mailing Address - Country:US
Mailing Address - Phone:706-546-8510
Mailing Address - Fax:706-546-4600
Practice Address - Street 1:700 OGLETHORPE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2221
Practice Address - Country:US
Practice Address - Phone:706-546-8510
Practice Address - Fax:706-546-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP891Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER