Provider Demographics
NPI:1073068631
Name:SWICEGOOD, BRITTANY SMITHSON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:SMITHSON
Last Name:SWICEGOOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:LAUREN
Other - Last Name:SMITHSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 15TH ST # OR6000
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-446-5941
Mailing Address - Fax:706-721-9286
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-5111
Practice Address - Country:US
Practice Address - Phone:706-721-8623
Practice Address - Fax:706-721-1459
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2991363AM0700X
GA8028363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA8028OtherGEORGIA COMPOSITE MEDICAL BOARD FOR PA