Provider Demographics
NPI:1760892616
Name:PATTILLO, DEVON BROOKE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DEVON
Middle Name:BROOKE
Last Name:PATTILLO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2979 WYNHAVEN OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-1305
Mailing Address - Country:US
Mailing Address - Phone:678-654-0822
Mailing Address - Fax:
Practice Address - Street 1:2383 PATE ST N
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3250
Practice Address - Country:US
Practice Address - Phone:770-972-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical