Provider Demographics
NPI:1104556455
Name:SCHLIES, NATHAN THOM (DO)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:THOM
Last Name:SCHLIES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 PINE BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2123
Mailing Address - Country:US
Mailing Address - Phone:706-464-3045
Mailing Address - Fax:
Practice Address - Street 1:1467 HARPER ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2600
Practice Address - Country:US
Practice Address - Phone:706-721-3157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine