Individual
NATHAN SCOTT LYCAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1968 PEACHTREE ROAD NW, ATLANTA, GA 30309
(404) 605-2800
(404) 351-5983
Mailing address
275 COLLIER RD NW, SUITE 500, ATLANTA, GA 30309-1709
(404) 605-2800
(404) 351-5983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
54202
CA
363AM0700X
Medical Physician Assistant
Primary
005811
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005811
GA LICENSE
GA
Enumeration date
07/25/2010
Last updated
09/20/2024
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