NPI age
12 years
Enumerated 2013-09-13
Across 1333 active physician assistant providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 7003 | LICENSE |
| 01 (GA) | 1093140659 | NPI |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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