Wall, Anthony
Wall, Anthony is an individual health care provider with primary practice located at 740 Prince Ave , Athens GA 30606-5908. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Wall, Anthony can be contacted via phone (706) 548-0008.Contact Information
Primary practice address
740 Prince Ave
Athens GA 30606-5908
Phone: (706) 548-0008
Fax: (706) 369-9673
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | R045285 | Georgia |
Profile Details
NPI number | 1740327139 |
---|---|
LBN Legal business name | Wall, Anthony |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 1st, 2007 |
Last updated | Feb 5th, 2018 - about 7 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 | 1740327139 | NPPES |
Georgia | MEDICAID | 988504591A |
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