Healthcare Provider Details

I. General information

NPI: 1043108483
Provider Name (Legal Business Name): WESLEY AARON ZILA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 JESSE JEWELL PKWY SE
GAINESVILLE GA
30501-3834
US

IV. Provider business mailing address

725 JESSE JEWELL PKWY SE
GAINESVILLE GA
30501-3834
US

V. Phone/Fax

Practice location:
  • Phone: 678-207-4000
  • Fax: 770-531-9000
Mailing address:
  • Phone: 678-207-4000
  • Fax: 770-531-9000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13345
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: