NPI age
19 years
Enumerated 2006-10-20
Across 4616 active physician assistant providers in Georgia.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 01184192 | AMERIGROUP |
| 01 | 582203199-009 | TRICARE AFFILIATION |
| 05 (GA) | 873868589D | |
| 05 (GA) | 873868589E | |
| 05 (SC) | 0584PA | |
| 05 (GA) | 873868589B | |
| 05 (GA) | 873868589K | |
| 01 (GA) | P00477553 | RR MEDICARE |
| 05 (GA) | 873868589J | |
| 05 (GA) | 873868589F | |
| 01 | 582203199-004 | TRICARE AFFILIATION |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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