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Individual

ANTONIO TOMBO LOPEZ JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1412 MILSTEAD AVE NE STE 300, CONYERS, GA 30012-3877
(404) 918-2320
(833) 605-2563
Mailing address
2001 PEACHTREE RD NE STE 645, ATLANTA, GA 30309-1476
(404) 482-9325
(883) 605-2563

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
APRN-NP249427
GA
363L00000X
Nurse Practitioner
Primary
APRN-NP249427
GA

Other

Enumeration date
10/17/2023
Last updated
10/21/2025
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