Gentry, Larry J
Gentry, Larry J is an individual health care provider with primary practice located at 1000 Johnson Ferry Rd Ne , Atlanta GA 30342-1606. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Gentry, Larry J can be contacted via phone (404) 851-8000.Contact Information
Primary practice address
1000 Johnson Ferry Rd Ne
Atlanta GA 30342-1606
Phone: (404) 851-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 001373 | Georgia |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 001373 | Georgia |
Profile Details
| NPI number | 1538113840 |
|---|---|
| LBN Legal business name | Gentry, Larry J |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 20th, 2006 |
| Last updated | Nov 13th, 2008 - about 18 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 | 1538113840 | NPPES |
| Georgia | Other | 10041973 | AMERIGROUP |
| Georgia | Other | 333479 | AMERIGROUP |
| Georgia | MEDICAID | 100002611B | AMERIGROUP |
| Georgia | MEDICAID | 100002611A | AMERIGROUP |
| Georgia | MEDICAID | 100002611 | AMERIGROUP |
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