| Mr Theron J Holtzclaw, AA | |
|
1968 Peachtree Road Nw, Atlanta, GA 30309-1281 | |
| (404) 351-1745 | |
| (404) 351-7121 |
| Full Name | Mr Theron J Holtzclaw |
|---|---|
| Gender | Male |
| Speciality | Anesthesiologist Assistant |
| Location | 1968 Peachtree Road Nw, Atlanta, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073538955 | NPI | - | NPPES |
| 100001111 | Medicaid | GA | |
| 100001111C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 002172 (Georgia) | Secondary |
| 367H00000X | Anesthesiologist Assistant | 002172 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Theron J Holtzclaw, AA Po Box 551420, Fort Lauderdale, FL 33355-1420 Ph: (800) 243-3839 | Mr Theron J Holtzclaw, AA 1968 Peachtree Road Nw, Atlanta, GA 30309-1281 Ph: (404) 351-1745 |
Matthew Lewis, PAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1405 Clifton Rd Ne Fl 3, Atlanta, GA 30322 Phone: 404-785-6670 Fax: 404-785-1362 | |
Elizabeth Ikeda, Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1365 Clifton Rd Ne, Atlanta, GA 30322 Phone: 404-778-8311 | |
Amar R Herndon, Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 Phone: 770-645-9181 | |
Shelley S Staton, PAAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1000 Johnson Ferry Rd, Atlanta, GA 30342 Phone: 770-645-9181 Fax: 770-645-8455 | |
Mr. Grant Michael Mury, PAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 550 Peachtree St Ne, Atlanta, GA 30308 Phone: 404-778-3900 | |
Ashley Schade, PAAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342 Phone: 706-543-3449 | |
Jiaqi Tracy Li, PAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1001 Johnson Fy Rd Ne, Atlanta, GA 30342 Phone: 404-785-2008 Fax: 404-785-4496 |