Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 75857 | GA |
Y | 208600000X | Surgeon | 75857 | GA |
N | 2086S0127X | Trauma Surgeon | 75857 | GA |
NPI | 1205192424 |
---|---|
Provider Name | Nathan John Klingensmith |
First Address | Atlanta, GA 30303 |
Second Address | Atlanta, GA 30303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2012 |
Last Update Date | 29/04/2021 |