Individual
MR. TIMOTHY J PARDOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
30 BUCHANAN BYP, BUCHANAN, GA 30113-4924
(770) 646-8281
(770) 646-3579
Mailing address
30 BUCHANAN BYP, BUCHANAN, GA 30113-4924
(770) 646-8281
(770) 646-3579
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003610
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002181A
—
GA
Enumeration date
10/31/2005
Last updated
07/28/2010
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