Healthcare Provider Details

I. General information

NPI: 1699241364
Provider Name (Legal Business Name): HEATHER MICHELLE HOBBS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER MICHELLE FARMER PA

II. Dates (important events)

Enumeration Date: 10/19/2018
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 SPRING ST NE
GAINESVILLE GA
30501
US

IV. Provider business mailing address

PO BOX 742616
ATLANTA GA
30374-2616
US

V. Phone/Fax

Practice location:
  • Phone: 770-219-9000
  • Fax: 770-219-6021
Mailing address:
  • Phone: 770-219-8420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number008996
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: