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NPI Code Detail

MEDICARE: ANTHONY VINCENT DITARANTO MD JD PC

MEDICARE: ANTHONY VINCENT DITARANTO MD JD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1801027008
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANTHONY VINCENT DITARANTO MD JD PC
Provider Business Mailing Address
First Line : 6031 BANBURY DR
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-2801
Country : US
Telephone Number : 706-536-4690
Fax Number : 706-596-8947
Provider Business Practice Location Address
First Line : 5131 WARM SPRINGS RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-4196
Country : US
Telephone Number : 706-561-1371
Fax Number : 706-561-4055
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : ANTHONY VINCENT DITARANTO
Credential :
Telephone Number : 706-536-4690
Provider Enumeration Date : 08/05/2009
Last Update Date : 10/19/2018

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