Threlkeld, Anisa B
Threlkeld, Anisa B is an sole proprietor health care provider with primary practice located at 980 Johnson Fy Rd Ne Suite 550, Atlanta GA 30342-1626. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Threlkeld, Anisa B can be contacted via phone (404) 631-6440.Contact Information
Primary practice address
980 Johnson Fy Rd Ne Suite 550
Atlanta GA 30342-1626
Phone: (404) 631-6440
Fax: (404) 631-6332
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 38988 | Georgia |
Profile Details
NPI number | 1316949365 |
---|---|
LBN Legal business name | Threlkeld, Anisa B |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 10th, 2005 |
Last updated | Jun 24th, 2019 - about 6 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 | 1316949365 | NPPES |
Georgia | MEDICAID | 000619077 |
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