Provider Demographics
NPI:1376890715
Name:THOMPSON, NATHAN ROBERT (AA)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:ROBERT
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:AA
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Mailing Address - Street 1:531 ROSELANE ST NW
Mailing Address - Street 2:SUITE 830
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6913
Mailing Address - Country:US
Mailing Address - Phone:770-794-0477
Mailing Address - Fax:770-794-3108
Practice Address - Street 1:677 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1101
Practice Address - Country:US
Practice Address - Phone:770-794-0477
Practice Address - Fax:770-794-3108
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2019-08-26
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant