| Prince Avenue Primary Care, L.l.c. | |
|
892 Prince Ave Athens GA 30606-2724 | |
| (706) 227-2027 | |
| (706) 227-2433 |
| Full Name | Prince Avenue Primary Care, L.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 892 Prince Ave, Athens, Georgia |
| Authorized Official Name and Position | Timothy B Gibson (CEO) |
| Authorized Official Contact | 7062272027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prince Avenue Primary Care, L.l.c. 892 Prince Ave Athens GA 30606-2724 Ph: (706) 227-2027 | Prince Avenue Primary Care, L.l.c. 892 Prince Ave Athens GA 30606-2724 Ph: (706) 227-2027 |
| NPI Number | 1386676211 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 12/28/2009 |
| Medicare PECOS PAC ID | 4688668346 |
|---|---|
| Medicare Enrollment ID | O20040414000612 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386676211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 015584 (Georgia) | Primary |
| Provider Name | Patricia A Siefferman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093709453 PECOS PAC ID: 3779562566 Enrollment ID: I20040715000784 |
| Provider Name | Madhusudan Chandora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376682971 PECOS PAC ID: 1052379328 Enrollment ID: I20050103000876 |
| Provider Name | Eduardo M Cossio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376711747 PECOS PAC ID: 2668420803 Enrollment ID: I20050105000136 |
| Provider Name | James B Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144200411 PECOS PAC ID: 4789612391 Enrollment ID: I20120529000578 |
James L. Brown, Jr., M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2090 Prince Ave, Building A, Athens, GA 30606 Phone: 706-548-3478 Fax: 706-543-7861 | |
Hillsman Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 870 Gaines School Rd, Athens, GA 30605 Phone: 762-499-6960 | |
Evirtualcare, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 555 Forest Rd, Athens, GA 30605 Phone: 706-502-0503 | |
Northeast Health District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 Research Dr, Athens, GA 30605 Phone: 706-583-2856 Fax: 706-369-5732 | |
Athens Regional Physician Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Oglethorpe Avenue, Suite 600a, Athens, GA 30606 Phone: 706-369-5440 Fax: 706-369-5490 | |
G. Steven Chesser Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 700 Sunset Dr, Bldg 500a Suite 502, Athens, GA 30606 Phone: 706-433-0741 Fax: 706-433-0746 | |
Athens Model Neighborhood Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 675 College Ave, Athens, GA 30601 Phone: 706-546-5526 Fax: 706-546-5687 |