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:
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Health care specialties

SpecialtyCodeLicense #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 8 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 1740327139 NPPES
Georgia MEDICAID 988504591A

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