OrganizationActive
Ent of Athens, LLC
NPI 1598822280 · Otolaryngology/Facial Plastic Surgery Physician · Athens, GA
Provider details
- NPI number
- 1598822280
- Entity type
- Organization
- Primary specialty
- Otolaryngology/Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Amy Ellis, Insurance Clerk
- License
- 12368 (GA)
Practice location
150 Nacoochee Ave
Athens, GA 30601-1823
Phone: (706) 546-7908
Fax: (706) 546-0918
Mailing address
150 Nacoochee Ave
Athens, GA 30601-1823
Registry dates
- Enumerated
- 2007-01-02
- Last updated
- 2012-06-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.