Healthcare Provider Details

I. General information

NPI: 1720095680
Provider Name (Legal Business Name): LARRY ONEAL FRANCE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 HARDEE AVE SW
FT MCPHERSON GA
30330-1062
US

IV. Provider business mailing address

706 NIGHTWIND WAY
STOCKBRIDGE GA
30281-9134
US

V. Phone/Fax

Practice location:
  • Phone: 404-464-6335
  • Fax: 404-464-7512
Mailing address:
  • Phone: 678-565-3480
  • Fax: 404-464-7512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: