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Preston Gantt, Md, Sa-c

Preston Gantt, Md, Sa-c is a health care provider in Colbert, GA. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 191 Valley Rd, Colbert, GA 30628, US
Practice Location Phone770-580-4929
Practice Location Fax
Legal Business NamePRESTON GANTT, MD, SA-C
NPI ?1366938086
Entity TypeOrganization
Enumeration Date ? Jul 5, 2018
Last Update Date ? Jul 9, 2018
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Preston Gantt, Md, Sa-c

SpecialtySpecializationLicenseLicense State
Point of Service

legacy-id-icon Legacy Provider IDs of Preston Gantt, Md, Sa-c

Provider IdIssuer StateIssuer TypeIssuer
1902304538GeorgiaMedicaid

official-icon Authorized Official of Preston Gantt, Md, Sa-c

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Preston Gantt, Md, Sa-c's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Dr. Preston Gantt (MD, SA-C)
Authorized Official Title/PositionOWNER
Authorized Official Phone Number770-580-4929