Individual
MS. ANDREA BYRD DOAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1067 PEACHTREE ST, LOUISVILLE, GA 30434
(478) 625-8471
(478) 625-8477
Mailing address
1067 PEACHTREE ST, LOUISVILLE, GA 30434-1558
(478) 625-8471
(478) 625-8477
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002743
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000139A
—
GA
05
—
100000139C
—
GA
05
—
100000140A
—
GA
Enumeration date
06/04/2006
Last updated
11/16/2018
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