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NPI Code Detail

MEDICARE: WHITNEY KNOWLTON PA

MEDICARE:   WHITNEY  KNOWLTON  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant8338GA

General Provider Information

NPI Number : 1982954921
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY KNOWLTON PA
Provider Business Mailing Address
First Line : 3320 OLD JEFFERSON RD BLDG 800
Second Line :
City : ATHENS
State : GA
Zip : 30607-1400
Country : US
Telephone Number : 706-353-2990
Fax Number : 706-353-4352
Provider Business Practice Location Address
First Line : 119 HARMONY XING STE 1
Second Line :
City : EATONTON
State : GA
Zip : 31024-9571
Country : US
Telephone Number : 762-220-1880
Fax Number : 762-220-1181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2012
Last Update Date : 07/19/2024

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Directions to “ WHITNEY KNOWLTON PA” Practice Location

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