Provider Demographics
NPI:1750324695
Name:WESTBERRY, PERRY MANSON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PERRY
Middle Name:MANSON
Last Name:WESTBERRY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2208
Mailing Address - Country:US
Mailing Address - Phone:404-881-9727
Mailing Address - Fax:404-523-9184
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1700
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2208
Practice Address - Country:US
Practice Address - Phone:404-881-9727
Practice Address - Fax:404-523-9184
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA001093363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA97WCCVZMedicare ID - Type UnspecifiedPROVIDER NUMBER
GAP59668Medicare UPIN