Provider Demographics
NPI:1821714908
Name:LIN, KAR (PA-C)
Entity Type:Individual
Prefix:
First Name:KAR
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:519 CALIBRE LAKE PKWY SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-7225
Mailing Address - Country:US
Mailing Address - Phone:678-308-4858
Mailing Address - Fax:
Practice Address - Street 1:3903 S COBB DR SE STE 200
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6301
Practice Address - Country:US
Practice Address - Phone:770-628-1367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11204207QA0505X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine