Poodiack, Kathy S

Poodiack, Kathy S is an individual health care provider with primary practice located at 1700 Hospital South Drive Suite 300, Austell GA 30106-8116. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Poodiack, Kathy S can be contacted via phone (770) 944-2830.

Contact Information

Primary practice address
1700 Hospital South Drive Suite 300 Austell GA 30106-8116
Fax: (678) 581-7170
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9104850 Florida

Profile Details

NPI number 1700030624
LBN Legal business name Poodiack, Kathy S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2008
Last updated Nov 10th, 2009 - about 17 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 1700030624 NPPES
Georgia Other 002325 STATE MEDICAL LICENSE
Georgia Other GRP245 STATE MEDICAL LICENSE

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