Individual
GARRETT AUSTIN FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 BRYAN BLVD, CORBIN, KY 40701-2775
(606) 523-2005
Mailing address
1615 MAIN ST, WILLIAMSBURG, KY 40769-1842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3024
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/24/2022
Last updated
12/16/2022
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