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NPI Code Detail

MEDICARE: ANTONIO WASHINGTON

MEDICARE: ANTONIO WASHINGTON
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
1106S00000XBehavior TechnicianGA

General Provider Information

NPI Number : 1164232690
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTONIO WASHINGTON
Provider Business Mailing Address
First Line : 1808 NORTHGATE DR
Second Line :
City : SAVANNAH
State : GA
Zip : 31404-4301
Country : US
Telephone Number : 912-631-2120
Fax Number :
Provider Business Practice Location Address
First Line : 806 TOWNE PARK DR
Second Line :
City : RINCON
State : GA
Zip : 31326-9368
Country : US
Telephone Number : 854-204-0440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2025
Last Update Date : 06/10/2026

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Directions to “ ANTONIO WASHINGTON ” Practice Location

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