Individual
MR. JEFFREY N HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106-6828
(770) 944-1100
(770) 941-7227
Mailing address
2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106-6828
(770) 944-1100
(770) 941-7227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002922
GA
363AS0400X
Surgical Physician Assistant
Primary
002922
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507133071E
—
GA
05
—
507133071F
—
GA
05
—
507133071G
—
GA
Enumeration date
05/07/2007
Last updated
07/11/2012
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