Individual
BRANDON LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3440 HIGHWAY 81, LOGANVILLE, GA 30052-9112
(770) 554-5009
(706) 546-8792
Mailing address
1765 OLD WEST BROAD ST BLDG 2-200, ATHENS, GA 30606-2887
(706) 549-1663
(706) 546-8792
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13100
GA
363A00000X
Physician Assistant
Primary
1659104933
GA
363AS0400X
Surgical Physician Assistant
1659104933
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16810684
CAQH NUMBER
—
Enumeration date
08/22/2024
Last updated
06/11/2026
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