Individual
KYLE CARTER BACHMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
61 WHITCHER ST NE STE 1100, MARIETTA, GA 30060-1177
(770) 422-3290
(770) 422-0287
Mailing address
61 WHITCHER ST NE STE 1100, MARIETTA, GA 30060-1177
(770) 422-3290
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004695
GA
363AM0700X
Medical Physician Assistant
004695
GA
363AS0400X
Surgical Physician Assistant
004695
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I978117
MEDICARE PTAN
GA
Enumeration date
05/09/2007
Last updated
07/16/2020
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