NPI 1003140351

Cardiovascular Group

Organisation Physician Assistant Lawrenceville, GA

Practice location

Address: 755 Walther Rd, Lawrenceville, GA 30046-8725
Phone: (678) 252-3707
Mailing address: 1051 Stone Shoals CT, Watkinsville, GA 30677-2774

Authorised official

Name: Mariah Wood Thaxton
Title: Physician Assistant
Phone: (478) 457-7128

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

Other Physician Assistant providers in Georgia →

Registry record

NPI: 1003140351
Entity type: Organization
NPI issued: 18 Sep 2009
Record last updated: 3 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.