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NPI 1962651414

NPI 1962651414 : BRIAN PURSER AA : FAYETTEVILLE, GA

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General NPI Number Information
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    NPI Number           |    1962651414
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    Entity Type          |    Individual 
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    Provider Name        |    BRIAN PURSER AA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/09/2008
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    Last Update Date     |    07/16/2024
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Provider Practice Location Address
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    Address Line         |    1255 HIGHWAY 54 W 
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    City                 |    FAYETTEVILLE
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    State                |    GA
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    Zip                  |    30214-4526
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    Country              |    US
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    Telephone            |    770-719-7000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1600 SW ARCHER RD 
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    City                 |    GAINESVILLE
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    State                |    FL
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    Zip                  |    32610-3003
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    Country              |    US
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    Telephone            |    352-273-8610
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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        |    367H00000X
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    Taxonomy Name        |    Anesthesiologist 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        |    367H00000X
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    Taxonomy Name        |    Anesthesiologist Assistant
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    License Number       |    AA31
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    License Number State |    FL
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Taxonomy #3
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    Taxonomy Code        |    367H00000X
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    Taxonomy Name        |    Anesthesiologist Assistant
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    License Number       |    5428
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    License Number State |    GA
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