| Boulevard Family Practice | |
|
1010 Prince Ave Ste 184 Athens GA 30606-5815 | |
| (706) 850-6134 | |
| Not Available |
| Full Name | Boulevard Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1010 Prince Ave Ste 184, Athens, Georgia |
| Authorized Official Name and Position | Thomas Weiner (PHYSICIAN) |
| Authorized Official Contact | 7068506134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulevard Family Practice 1010 Prince Ave Ste 184 Athens GA 30606-5815 Ph: (706) 850-6134 | Boulevard Family Practice 1010 Prince Ave Ste 184 Athens GA 30606-5815 Ph: (706) 850-6134 |
| NPI Number | 1508392267 |
|---|---|
| Provider Enumeration Date | 05/02/2017 |
| Last Update Date | 05/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508392267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 72846 (Georgia) | Primary |
| 207Q00000X | Family Medicine | 72811 (Georgia) | Secondary |
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