Healthcare Provider Details

I. General information

NPI: 1386987857
Provider Name (Legal Business Name): PATRICK MCANALLY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2013
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 TREE LN STE 250
SNELLVILLE GA
30078-6799
US

IV. Provider business mailing address

4519 WOODRUFF RD SUITE 4 PMB 349
COLUMBUS GA
31904-6011
US

V. Phone/Fax

Practice location:
  • Phone: 770-736-6300
  • Fax:
Mailing address:
  • Phone: 706-653-2255
  • Fax: 706-653-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number006788
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: