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Individual

ONYEBUCHI NEITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
710 NEWNAN CROSSING BYP, NEWNAN, GA 30263-2384
(770) 251-5111
Mailing address
7300 RANCH ROAD 2222, BUILDING 1, STE 200, AUSTIN, TX 78730
(512) 628-0465
(512) 233-2711

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005791
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202I972739
MEDICARE ID
GA
01
P01268623
RAILROAD MEDICARE
GA
Enumeration date
07/01/2013
Last updated
03/31/2023
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