Individual provider · Type 1 NPI

Madison Mandula Bazemore, PA

Physician Assistant · Gainesville, GA

NPI number 1306583323 Active

Practice location

1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3875

Call (770) 848-6190 Map

Mailing address

PO Box 742616
Atlanta, GA 30374-2616

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Physician Assistant Primary 363A00000X11992 (GA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1306583323

Madison Mandula Bazemore, PA's National Provider Identifier is 1306583323, issued on May 20, 2022. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Gainesville, GA. The record was last updated on Dec 20, 2023.