Provider Demographics
NPI:1396419826
Name:BINION, AIRICA AVERY
Entity Type:Individual
Prefix:
First Name:AIRICA
Middle Name:AVERY
Last Name:BINION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 JOHN TRAMMELL RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30251-2101
Mailing Address - Country:US
Mailing Address - Phone:678-633-2005
Mailing Address - Fax:
Practice Address - Street 1:1330 HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-2950
Practice Address - Country:US
Practice Address - Phone:770-631-2502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-07
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10549363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant