Provider Demographics
NPI:1083218507
Name:SACHHATHEP, VARIN (PA-C)
Entity Type:Individual
Prefix:
First Name:VARIN
Middle Name:
Last Name:SACHHATHEP
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 HAMILTON CREEK PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7285
Mailing Address - Country:US
Mailing Address - Phone:770-586-0300
Mailing Address - Fax:
Practice Address - Street 1:2075 HAMILTON CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7285
Practice Address - Country:US
Practice Address - Phone:770-586-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9893363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical