Individual
GRANT THOMAS LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1445 OLD MCDONOUGH HWY SE, SUITE E, CONYERS, GA 30094-7788
(770) 922-9222
(770) 504-6318
Mailing address
6175 NEWTON DR NE, COVINGTON, GA 30014-2690
(770) 787-6900
(770) 787-6962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
004108
GA
363AM0700X
Medical Physician Assistant
Primary
004108
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003200095A
—
GA
01
—
004108
PA LICENSE NUMBER
GA
Enumeration date
05/11/2006
Last updated
05/23/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us