# MR. BRIAN BADGER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568469518
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 3435 | GA | Yes |
| 363AM0700X | Medical Physician Assistant | PA3752 | FL | — |

## Other

- **Enumeration date:** 07/06/2005
- **Last updated:** 02/11/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 003435 | STSTE LICENSE \# | GA |
| 05 | — | 100000360C | — | GA |
| 01 | — | 606478700 | DEPT OF LABOR | FL |
| 01 | — | 96317 | HEALTH PARTNERS | FL |
| 01 | — | PA3752 | LICENSE \# | FL |