Provider Demographics
NPI:1093896151
Name:ANTIGNANO, LOUIS VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:VINCENT
Last Name:ANTIGNANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 POINT NORTH PL
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2644
Mailing Address - Country:US
Mailing Address - Phone:706-272-4127
Mailing Address - Fax:706-279-3969
Practice Address - Street 1:302 POINT NORTH PL
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2644
Practice Address - Country:US
Practice Address - Phone:706-272-4127
Practice Address - Fax:706-279-3969
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154491207RG0100X
GA079536207RG0100X
NC2011-00588207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology