Baldizon, Nestor Antonio

Baldizon, Nestor Antonio is an individual health care provider with primary practice located at 148 Clinic Ave , Carrollton GA 30117-4414. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Baldizon, Nestor Antonio can be contacted via phone (770) 838-8640.

Contact Information

Primary practice address
148 Clinic Ave Carrollton GA 30117-4414
Phone: (770) 838-8640
Fax: (770) 838-8650
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004239 Georgia

Profile Details

NPI number 1427049717
LBN Legal business name Baldizon, Nestor Antonio
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Jun 30th, 2014 - about 12 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 1427049717 NPPES
Georgia MEDICAID 253274100B

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