Individual provider · Type 1 NPI

Grant Thomas Land, PA-C

Medical Physician Assistant · Conyers, GA

NPI number 1508816570 Active

Practice location

1445 Old Mcdonough Hwy SE, Suite E
Conyers, GA 30094-7788

Call (770) 922-9222 Map

Fax (770) 504-6318

Mailing address

6175 Newton Dr NE
Covington, GA 30014-2690

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000X004108 (GA)
Medical Physician Assistant Primary 363AM0700X004108 (GA)

Medical Physician Assistant: Definition to come...

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About NPI 1508816570

Grant Thomas Land, PA-C's National Provider Identifier is 1508816570, issued on May 11, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Conyers, GA. The record was last updated on May 23, 2024.