NPI age
13 years
Enumerated 2013-03-13
Across 640 active physician assistant providers in Georgia.
5 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 006742 | STATE LICENSE |
| 05 (AL) | 147458 | |
| 05 (GA) | 003132870 |
Part of a multi-provider practice. 91 other active providers share this practice address in NPPES.
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