Basic Information
| Provider Information | |||||||||
| NPI: | 1104556455 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHLIES | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | THOM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 PINE BRANCH CT | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319092123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7064643045 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1467 HARPER ST | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309012600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067213157 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2022 | ||||||||
| LastUpdateDate: | 06/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 13870 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.