Provider Demographics
NPI:1538791579
Name:ATHENS CLARKE MEDICAL ENTERPRISES LLC
Entity type:Organization
Organization Name:ATHENS CLARKE MEDICAL ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRIEST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-207-9960
Mailing Address - Street 1:PO BOX 26544
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2016
Mailing Address - Country:US
Mailing Address - Phone:770-874-5400
Mailing Address - Fax:
Practice Address - Street 1:5401 LAKE OCONEE PKWY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-4232
Practice Address - Country:US
Practice Address - Phone:706-453-7331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty