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General NPI Number Information
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NPI Number | 1083965917
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Entity Type | Individual
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Provider Name | BRANDON LEE ESHLEMAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 5009 ROSWELL RD STE 201
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City | ATLANTA
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State | GA
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Zip | 30342-2205
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Country | US
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Telephone | 404-264-9553
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Fax | 404-266-2294
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Provider Business Mailing Address
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Address Line | 5009 ROSWELL RD STE 201
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City | ATLANTA
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State | GA
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Zip | 30342-2205
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Country | US
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Telephone | 404-264-9553
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Fax | 404-266-2294
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 006606
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License Number State | GA
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