Provider Demographics
NPI:1609091289
Name:SAUNDERS, HORACE A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:HORACE
Middle Name:A
Last Name:SAUNDERS
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 1:1505 NORTHSIDE BLVD.
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041
Mailing Address - Country:US
Mailing Address - Phone:770-781-5077
Mailing Address - Fax:770-781-3915
Practice Address - Street 1:1505 NORTHSIDE BLVD.
Practice Address - Street 2:SUITE 1500
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041
Practice Address - Country:US
Practice Address - Phone:770-781-5077
Practice Address - Fax:770-781-3915
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005032207N00000X, 207NS0135X, 207NP0225X, 363A00000X
GA5032363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA318517267EMedicaid