Individual
ANTHONY JOHN POTHOULAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 PHILIP BLVD STE 100, LAWRENCEVILLE, GA 30046-8736
(770) 995-3300
(770) 995-3307
Mailing address
10600 MEDLOCK BRIDGE RD, DULUTH, GA 30097-8404
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
072758
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003151345
—
GA
Enumeration date
07/18/2005
Last updated
01/14/2023
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