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CHARLES BAKER PHYSICIAN ASSISTANCE

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1477597946

Individual Registrant:
 CHARLES  BAKER PHYSICIAN ASSISTANCE
Gender: M
Sole Proprietor

Location and contact information for practice:
334 SMITH AVE  THOMASVILLE, GA 31792-5533 US
Tel: 229-227-1595  Fax: 229-227-1385

Contact information for business:
334 SMITH AVE  THOMASVILLE, GA 31792-5533 US
Tel: 229-227-1595  Fax: 229-227-1385

Registration Information:
NPI: 1477597946
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
GA003660

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
100001820PGA05




HEALTH CARE JOBS GA - Page 1



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