Provider Demographics
NPI:1346547569
Name:PRICE, ERIN MCLEAN (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MCLEAN
Last Name:PRICE
Suffix:
Gender:F
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 1:1605 HIGHWAY 34 E
Mailing Address - Street 2:STE #A2
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2191
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1605 HIGHWAY 34 E
Practice Address - Street 2:STE #A2
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2191
Practice Address - Country:US
Practice Address - Phone:770-251-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6054363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant