Pothoulakis, Anthony John

Pothoulakis, Anthony John is an individual health care provider with primary practice located at 475 Philip Blvd Ste 100 , Lawrenceville GA 30046-8736. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Pothoulakis, Anthony John can be contacted via phone (770) 995-3300.

Contact Information

Primary practice address
475 Philip Blvd Ste 100 Lawrenceville GA 30046-8736
Phone: (770) 995-3300
Fax: (770) 995-3307
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 072758 Georgia

Profile Details

NPI number 1548269012
LBN Legal business name Pothoulakis, Anthony John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Jan 14th, 2023 - about 3 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 1548269012 NPPES
Georgia MEDICAID 003151345

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