Pothoulakis, Anthony John
Pothoulakis, Anthony John is an individual health care provider with primary practice located at 475 Philip Blvd Ste 100 , Lawrenceville GA 30046-8736. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Pothoulakis, Anthony John can be contacted via phone (770) 995-3300.Contact Information
Primary practice address
475 Philip Blvd Ste 100
Lawrenceville GA 30046-8736
Phone: (770) 995-3300
Fax: (770) 995-3307
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 072758 | Georgia |
Profile Details
| NPI number | 1548269012 |
|---|---|
| LBN Legal business name | Pothoulakis, Anthony John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2005 |
| Last updated | Jan 14th, 2023 - about last year |
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 | 1548269012 | NPPES |
| Georgia | MEDICAID | 003151345 |
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