Provider Demographics
NPI:1093778797
Name:ADDINGTON, TONY KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:KEITH
Last Name:ADDINGTON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:229-391-3686
Practice Address - Street 1:2142 W BROAD ST BLDG 200
Practice Address - Street 2:KAISER PERMANENTE ATHENS MEDICAL CENTER
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3509
Practice Address - Country:US
Practice Address - Phone:706-583-5000
Practice Address - Fax:229-391-3686
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2022-01-07
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Provider Licenses
StateLicense IDTaxonomies
GA052526174400000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA803014102AMedicaid
GA803014102BMedicaid