Healthcare Provider Details

I. General information

NPI: 1134779770
Provider Name (Legal Business Name): KATHERINE SZAKAL BRIDGES PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE E SZAKAL

II. Dates (important events)

Enumeration Date: 09/16/2019
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 S WEST ST
BAINBRIDGE GA
39819-3918
US

IV. Provider business mailing address

406 S WEST ST
BAINBRIDGE GA
39819-3918
US

V. Phone/Fax

Practice location:
  • Phone: 229-246-6417
  • Fax: 229-246-2041
Mailing address:
  • Phone: 229-246-6417
  • Fax: 229-246-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9430
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: