Provider Demographics
NPI:1962052167
Name:CAAP MEDICAL GROUP
Entity type:Organization
Organization Name:CAAP MEDICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-247-5605
Mailing Address - Street 1:700 SUNSET DR STE 601
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7720
Mailing Address - Country:US
Mailing Address - Phone:706-549-4155
Mailing Address - Fax:706-549-1119
Practice Address - Street 1:700 SUNSET DR STE 601
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7720
Practice Address - Country:US
Practice Address - Phone:706-549-4155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty