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General NPI Number Information
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NPI Number | 1184366445
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Entity Type | Individual
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Provider Name | AUSTIN CHRISTOPHER TAYLOR PA-S, ATC
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Gender | Male
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 2600 CENTURY PKWY NE
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City | ATLANTA
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State | GA
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Zip | 30345-3125
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Country | US
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Telephone | 470-322-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 8558 LAKE FORREST DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-2228
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Country | US
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Telephone | 770-853-6961
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT004170
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License Number State | GA
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