MEDICARE: BRITTANY PARK JEFFERS P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	6118	GA

General Provider Information

NPI Number	:	1063702900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY PARK JEFFERS P.A.

Provider Business Mailing Address
First Line	:	478 LINDBERGH PL NE
Second Line	:	APT 231
City	:	ATLANTA
State	:	GA
Zip	:	30324-3313
Country	:	US
Telephone Number	:	919-306-4963
Fax Number	:

Provider Business Practice Location Address
First Line	:	148 BILL CARRUTH PKWY STE 180
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-3756
Country	:	US
Telephone Number	:	770-445-4915
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2011
Last Update Date	:	04/17/2025

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Directions to “ BRITTANY PARK JEFFERS P.A.” Practice Location

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