Provider Demographics
NPI:1568499754
Name:PITTS, CHRISTOPHER ALLEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:PITTS
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 1:2011 COMMERCE DR N
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3538
Mailing Address - Country:US
Mailing Address - Phone:912-536-3784
Mailing Address - Fax:478-352-0095
Practice Address - Street 1:2011 COMMERCE DR N
Practice Address - Street 2:SUITE 25
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3538
Practice Address - Country:US
Practice Address - Phone:678-672-2220
Practice Address - Fax:855-491-8879
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003864363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1053815OtherNCCPA CERTIFICATION
GA862532359EMedicaid
GA008564OtherLICENSE
SCPA3089OtherLICENSE (SC)
GA1053815OtherNCCPA CERTIFICATION