Patricia J Eubank, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2284 Issued in GA

Practice address

631 Professional Dr
Ste 360
Lawrenceville, GA 30046-3367

Phone

(770) 962-4895

Fax

(770) 962-4792

NPI assigned

Nov 20, 2006

Last updated

Jan 10, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1881768927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR",
            "address_2": "STE 360",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463367",
            "telephone_number": "770-962-4895",
            "fax_number": "770-962-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR",
            "address_2": "STE 360",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463367",
            "telephone_number": "770-962-4895",
            "fax_number": "770-962-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANK",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "2284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "616293304A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamera Etchison
• Etf Care LLC
• Jerry Ethridge
• Benedict Etumnu
• Jessica Etzkorn, FNP-C
• Haley Marie Eubanks
• Eugene Medical Clinic
• Beatrixe Claude Eugene, D.O.
• Jocelyn Claire Evans-Shaw
• Darmetria Evans

• Medical Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.