Provider Demographics
NPI:1467851212
Name:NOON, ALAN (PA-C)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:NOON
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 1:6392 MURPHY DR
Mailing Address - Street 2:PO BOX 6
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-1714
Mailing Address - Country:US
Mailing Address - Phone:770-960-5701
Mailing Address - Fax:
Practice Address - Street 1:6392 MURPHY DR
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-1714
Practice Address - Country:US
Practice Address - Phone:770-960-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2242363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant