Provider Demographics
NPI: | 1871476275 |
---|---|
Name: | CLARKE COUNTY DEPARTMENT OF HEALTH |
Entity type: | Organization |
Organization Name: | CLARKE COUNTY DEPARTMENT OF HEALTH |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | HEALTH DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DONALD |
Authorized Official - Middle Name: | S |
Authorized Official - Last Name: | GOGGANS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 706-583-2870 |
Mailing Address - Street 1: | 345 N HARRIS ST |
Mailing Address - Street 2: | |
Mailing Address - City: | ATHENS |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30601-2411 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 706-389-6921 |
Mailing Address - Fax: | 706-389-6897 |
Practice Address - Street 1: | 410 MCKINLEY DR |
Practice Address - Street 2: | |
Practice Address - City: | ATHENS |
Practice Address - State: | GA |
Practice Address - Zip Code: | 30601-3270 |
Practice Address - Country: | US |
Practice Address - Phone: | 706-227-4409 |
Practice Address - Fax: | 706-354-3966 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | CLARKE COUNTY DEPARTMENT OF HEALTH |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2025-07-31 |
Last Update Date: | 2025-07-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QP0905X | Ambulatory Health Care Facilities | Clinic/Center | Public Health, State or Local |