Provider Demographics
NPI:1487821187
Name:THORNTON, JONATHAN ANDREW (PA)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ANDREW
Last Name:THORNTON
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:747 RALPH MCGILL BLVD NE UNIT 236
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1131
Mailing Address - Country:US
Mailing Address - Phone:912-713-2378
Mailing Address - Fax:404-265-4755
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2212
Practice Address - Country:US
Practice Address - Phone:404-686-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2022-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA005326363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant