NPI age
20 years
Enumerated 2005-08-12
Across 1333 active physician assistant providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TN) | 4355303 | BCBST |
| 01 (TN) | 1823 | STATE MEDICAL LICENSE |
| 05 (TN) | 1518338 | |
| 01 (TN) | P01237854 | RAILROAD MEDICARE |
| 01 (TN) | 1518338 | BLUECARE |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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