Provider Demographics
NPI:1285304543
Name:THORNE, ANTHONY C
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:C
Last Name:THORNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 DRUID HILLS RESERVE DR NE # 3101
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2041
Mailing Address - Country:US
Mailing Address - Phone:912-548-3043
Mailing Address - Fax:
Practice Address - Street 1:3101 DRUID HILLS RESERVE DR NE # 3101
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2041
Practice Address - Country:US
Practice Address - Phone:912-548-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant