Provider Demographics
NPI:1780356220
Name:NATIONS, JUSTIN CLAY
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:CLAY
Last Name:NATIONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 SHORTER AVE SW STE 102
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-4292
Mailing Address - Country:US
Mailing Address - Phone:706-234-2001
Mailing Address - Fax:
Practice Address - Street 1:413 SHORTER AVE SW STE 102
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-4292
Practice Address - Country:US
Practice Address - Phone:706-234-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS001107237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist