NPI age
19 years
Enumerated 2007-01-04
Across 640 active physician assistant providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 02-151 | SURGICAL ASSISTANT-CERTIFIED |
| 01 (IL) | 238.000307 | REGISTRATION |
| 01 (CO) | SA.0001689 | COLORADO STATE LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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