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
Fax: (404) 631-6332
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316949365 NPPES
Georgia MEDICAID 000619077

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