NPI age
20 years
Enumerated 2005-11-22
Across 4616 active physician assistant providers in Georgia.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 | 12639479 | CAQH NUMBER |
Part of a multi-provider practice. 90 other active providers share this practice address in NPPES.
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