Individual
GILLIAN VAUGHAN HEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1275 GA-54 #201, FAYETTEVILLE, GA 30214
(770) 461-3776
Mailing address
12484 WOODBURY HWY, GREENVILLE, GA 30222
(770) 823-3879
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9715
GA
Other
Enumeration date
04/06/2020
Last updated
11/25/2024
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