Clarke Oconee Family Medicine, Llc | |
700 Sunset Dr Ste 400a Athens GA 30606-2293 | |
(706) 353-7747 | |
(706) 353-7756 |
Full Name | Clarke Oconee Family Medicine, Llc |
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Speciality | Family Medicine |
Location | 700 Sunset Dr Ste 400a, Athens, Georgia |
Authorized Official Name and Position | Jonathan Mitchell Cook (OWNER/MANAGER) |
Authorized Official Contact | 7063537747 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clarke Oconee Family Medicine, Llc Po Box 7336 Athens GA 30604-7336 Ph: (706) 353-7747 | Clarke Oconee Family Medicine, Llc 700 Sunset Dr Ste 400a Athens GA 30606-2293 Ph: (706) 353-7747 |
NPI Number | 1801803820 |
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Provider Enumeration Date | 08/02/2006 |
Last Update Date | 11/13/2023 |
Medicare PECOS PAC ID | 2961392311 |
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Medicare Enrollment ID | O20040318000762 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801803820 | NPI | - | NPPES |
1467443713 | Other | GA | NPI PHYSICIAN |
169764070A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 042549 (Georgia) | Primary |
Provider Name | Jonathan M Cook |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467443713 PECOS PAC ID: 3971493339 Enrollment ID: I20040319000435 |
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