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NPI Code Detail

MEDICARE: ANTHONY JOHN LABADIA PA-C

MEDICARE: ANTHONY JOHN LABADIA PA-C
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
1363AS0400XSurgical Physician Assistant003042GA

General Provider Information

NPI Number : 1992787667
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY JOHN LABADIA PA-C
Provider Business Mailing Address
First Line : 258 CASSON ST NE
Second Line :
City : ATLANTA
State : GA
Zip : 30307-2210
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1670 CLAIRMONT RD
Second Line :
City : DECATUR
State : GA
Zip : 30033-4004
Country : US
Telephone Number : 404-321-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 07/08/2007

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Directions to “ ANTHONY JOHN LABADIA PA-C” Practice Location

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