Individual
MR. MICHAEL BRIAN WITHERSPOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1255 HWY 54 W, FAYETTEVILLE, GA 30214
(770) 793-5000
Mailing address
18167 US HWY. 19 N #650, CLEARWATER, FL 33764
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6837
GA
Other
Enumeration date
06/16/2013
Last updated
09/24/2015
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