Provider Demographics
NPI:1649779398
Name:KAZINEC, JOEL B (PA-C, MMSC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:B
Last Name:KAZINEC
Suffix:
Gender:M
Credentials:PA-C, MMSC
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Mailing Address - Street 1:3230 POST WOODS DR APT B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3441
Mailing Address - Country:US
Mailing Address - Phone:404-353-5569
Mailing Address - Fax:
Practice Address - Street 1:141 LACY ST NW STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1118
Practice Address - Country:US
Practice Address - Phone:770-426-7177
Practice Address - Fax:770-426-7745
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant