Individual
MRS. CRYSTAL D GAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1235 FRIENDSHIP RD STE 100, BRASELTON, GA 30517-5624
(770) 536-4352
(770) 532-8165
Mailing address
2406 LIGHTHOUSE MANOR DR, GAINESVILLE, GA 30501-7401
(770) 536-4352
(770) 532-8165
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003248
GA
363AM0700X
Medical Physician Assistant
3248
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP4727
GROUP PROVIDER ID
GA
Enumeration date
08/22/2006
Last updated
03/15/2022
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