Individual
MR. GERALD A ERICKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
260 ELM ST, CUMMING, GA 30040-2467
(770) 887-1668
(770) 781-9937
Mailing address
PO BOX 307, CUMMING, GA 30028-0307
(770) 887-1668
(770) 781-9937
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004309
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004309
GA PHYS ASSISTANT LIC #
GA
Enumeration date
07/07/2005
Last updated
08/25/2011
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