Individual
KENNETH BROOKE BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1336 HIGHWAY 54 W BLDG 500, FAYETTEVILLE, GA 30214-4574
(770) 461-1238
(770) 460-6610
Mailing address
1336 HIGHWAY 54 W BLDG 500, FAYETTEVILLE, GA 30214-4574
(770) 461-1238
(770) 460-6610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9270
GA
363AS0400X
Surgical Physician Assistant
Primary
9270
GA
Other
Enumeration date
08/28/2019
Last updated
04/24/2026
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