Marion McCauley Earnhardt, P.A.

Key facts

NPI

1265477186

Entity type

Individual (NPI type 1)

Primary specialty

Surgical Physician Assistant 363AS0400X

License

003245 (GA)

Practice address

5115 New Peachtree Rd
Suite 202
Chamblee, GA 30341-3326

Phone

(678) 672-2177

NPI assigned

Jun 17, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 23, 2011.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1265477186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 GENTRY WALK CT",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417484",
            "telephone_number": "770-722-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 NEW PEACHTREE RD",
            "address_2": "SUITE 202",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303413326",
            "telephone_number": "678-672-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARNHARDT",
        "first_name": "MARION",
        "middle_name": "MCCAULEY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "003245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Chamblee, GA · Surgical Physician Assistant in Georgia