Organization
ANTONIO LUIS, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS BRADDY (PRACTICE ADMINISTRATOR)
(478) 295-0526
Entity
Organization
Contact information
Practice address
1013 FERNWOOD DR STE C, MILLEDGEVILLE, GA 31061-5428
(478) 251-6924
(478) 295-3644
Mailing address
1013 FERNWOOD DR STE C, MILLEDGEVILLE, GA 31061-5428
(478) 251-6924
(478) 295-3644
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
08/30/2022
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