Thomas W. Bantly, M.D., P.C

LBN: Thomas W. Bantly, M.D., P.C
Thomas W. Bantly, M.D., P.C is an health care organization with primary practice located at 1700 Tree Lane Road Suite 260, Snellville GA 30078-6782. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as the primary health care specialty. Thomas W. Bantly, M.D., P.C can be contacted via phone (770) 736-7534, or through Bantly, Thomas W. via phone (770) 738-7534.

Contact Information

Primary practice address
1700 Tree Lane Road Suite 260 Snellville GA 30078-6782
Phone: (770) 736-7534
Fax: (770) 736-8627
Website:
Map and Directions
Authorized official contact:
Name: Bantly, Thomas W. Doctor of Medicine (MD)
Phone: (770) 738-7534

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X

Profile Details

NPI number 1356594709
LBN Legal business name Thomas W. Bantly, M.D., P.C
DBA Doing business as
Authorized official Bantly, Thomas W. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 29th, 2008
Last updated Oct 29th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356594709 NPPES
Georgia MEDICAID 000275877B

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