Individual provider · Type 1 NPI

Antonio Tombo Lopez Jr., NP

Nurse Practitioner · Conyers, GA

NPI number 1952183774 Active

Practice location

1412 Milstead Ave NE Ste 300
Conyers, GA 30012-3877

Call (404) 918-2320 Map

Fax (833) 605-2563

Mailing address

2001 Peachtree Rd NE Ste 645
Atlanta, GA 30309-1476

Specialties and licenses

Taxonomy	Code	License
Hematology & Oncology Physician	207RH0003X	APRN-NP249427 (GA)
Nurse Practitioner Primary	363L00000X	APRN-NP249427 (GA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1952183774

Antonio Tombo Lopez Jr., NP's National Provider Identifier is 1952183774, issued on Oct 17, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Conyers, GA. The record was last updated on Oct 21, 2025.