MR. THERON J HOLTZCLAW AA
NPI 1073538955
Anesthesiologist Assistant in Atlanta, GA

Active since July 13, 2006
1968 PEACHTREE ROAD NW, ATLANTA, GA 30309(404) 351-1745(404) 351-7121 Get Directions Write a Review

NPPES record last updated: October 1, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Theron J Holtzclaw Aa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. THERON J HOLTZCLAW AA (NPI 1073538955) is an individual anesthesiologist assistant in Atlanta, Georgia, licensed in Georgia (002172) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1073538955
Entity TypeIndividualMale
Primary Taxonomy367H00000X
Provider Legal NameMR. THERON J HOLTZCLAWCredential: AA
Location Address1968 PEACHTREE ROAD NWAtlanta, GA 30309-1281
Mailing AddressPo Box 551420Fort Lauderdale, FL 33355-1420 · (800) 243-3839 · Fax (954) 839-2569
Fax(404) 351-7121
Sole ProprietorNo
Enumeration DateJuly 13, 2006
Last NPPES UpdateOctober 1, 2010
NPI 1073538955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367H00000X
License Licensed in GA · 002172
Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

Also ListedPhysician AssistantTaxonomy 363A00000X · License 002172 (GA)
1968 PEACHTREE ROAD NW, Atlanta, GA 30309

Other Identifiers 5

Medicare UPINR11759
Medicaid100001111GA
Medicaid100001111CGA
Medicare PIN43ZCBJA17
Medicare ID-Type Unspecified97BBCXX

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Anesthesiology
1968 PEACHTREE ROAD NW
ATLANTA, GA 30309
Anesthesiologist Assistant
1968 PEACHTREE ROAD NW
ATLANTA, GA 30309
Anesthesiologist Assistant
1968 PEACHTREE ROAD NW
ATLANTA, GA 30309
Anesthesiologist Assistant
1968 PEACHTREE ROAD NW
ATLANTA, GA 30309
Nurse Anesthetist, Certified Registered
1968 PEACHTREE ROAD NW
ATLANTA, GA 30309
Emergency Medicine
1968 PEACHTREE ROAD NW
ATLANTA, GA 30309
Anesthesiology
1968 PEACHTREE ROAD NW
ATLANTA, GA 30309
Anesthesiologist Assistant
1968 PEACHTREE ROAD NW
ATLANTA, GA 30309

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theron Holtzclaw's NPI number?

The NPI number for Theron Holtzclaw is 1073538955. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Theron Holtzclaw located?

Theron Holtzclaw practices at 1968 Peachtree Road NW, Atlanta, GA 30309. The listed phone number is (404) 351-1745.

What is Theron Holtzclaw's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

When was this NPI record last updated?

The NPPES record for Theron Holtzclaw was last updated on October 1, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.