ANTHONY J. POTHOULAKIS MD – NPI #1548269012
Internal Medicine

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

ANTHONY POTHOULAKIS is a physician located in LAWRENCEVILLE, GA. NPPES has assigned the NPI number 1548269012 to ANTHONY POTHOULAKIS on July 18, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207RC0000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Cardiovascular Disease

The NPI profile was previously updated about 3 years ago on Jan 14, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ANTHONY POTHOULAKIS below.

NPI Profile for
ANTHONY J. POTHOULAKIS

NPI Number
1548269012
Enumeration Date

(about 21 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
ANTHONY J. POTHOULAKIS
Credentials
MD
Primary location
475 PHILIP BLVD STE 100
LAWRENCEVILLE, GA 30046-8736
Phone: (770) 995-3300 Fax: (770) 995-3307
Mailing address
10600 MEDLOCK BRIDGE RD
DULUTH, GA 30097-8404
Phone: Fax:
Sole Proprietor
No
Updated
Certification Date
Jan 12, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for ANTHONY POTHOULAKIS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidGA003151345
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RC0000X
- Internal Medicine / Cardiovascular Disease (Primary)
GA 072758

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Medicare Ordering & Referring
Provider can:
  • Order Durable Medical Equipment
  • Order Power Mobility Devices

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How do I correct or change the NPI data displayed here?
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Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.