Provider Demographics
NPI:1023386562
Name:SALAZAR, BETH ANN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:GUNDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2045 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1414
Mailing Address - Country:US
Mailing Address - Phone:404-351-7546
Mailing Address - Fax:404-352-4706
Practice Address - Street 1:2045 PEACHTREE RD NE
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1414
Practice Address - Country:US
Practice Address - Phone:404-351-7546
Practice Address - Fax:404-352-4706
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2232363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant