Latham, Angela S

Latham, Angela S is an individual health care provider with primary practice located at 2705 Wildwood Dr , Brunswick GA 31520-4346. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Latham, Angela S can be contacted via phone (912) 264-6133.

Contact Information

Primary practice address
2705 Wildwood Dr Brunswick GA 31520-4346
Fax: (912) 267-1415
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 004297 Georgia

Profile Details

NPI number 1043225634
LBN Legal business name Latham, Angela S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2006
Last updated Feb 11th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043225634 NPPES
Georgia MEDICAID 084105015A

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