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General NPI Number Information
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NPI Number | 1134675481
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Entity Type | Individual
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Provider Name | JOSEPH FLYNN DREVLOW PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 10905 HAYNES BRIDGE RD
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City | ALPHARETTA
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State | GA
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Zip | 30022-4807
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Country | US
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Telephone | 770-343-9898
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Fax |
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Provider Business Mailing Address
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Address Line | 10905 HAYNES BRIDGE RD
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City | ALPHARETTA
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State | GA
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Zip | 30022-4807
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Country | US
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Telephone | 706-626-3980
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Fax |
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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 | 11373
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License Number State | GA
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