Baldizon, Nestor Antonio
Baldizon, Nestor Antonio is an individual health care provider with primary practice located at 148 Clinic Ave , Carrollton GA 30117-4414. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Baldizon, Nestor Antonio can be contacted via phone (770) 838-8640.Contact Information
Primary practice address
148 Clinic Ave
Carrollton GA 30117-4414
Phone: (770) 838-8640
Fax: (770) 838-8650
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 004239 | Georgia |
Profile Details
NPI number | 1427049717 |
---|---|
LBN Legal business name | Baldizon, Nestor Antonio |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 4th, 2005 |
Last updated | Jun 30th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1427049717 | NPPES |
Georgia | MEDICAID | 253274100B |
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