Provider Demographics
NPI:1184909897
Name:TOWNSEND, RAY THOMAS (PA-C)
Entity type:Individual
Prefix:
First Name:RAY
Middle Name:THOMAS
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:56 HOSPITAL ST
Mailing Address - Street 2:PO BOX 409
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-3251
Mailing Address - Country:US
Mailing Address - Phone:706-896-2289
Mailing Address - Fax:706-896-6007
Practice Address - Street 1:56 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-3251
Practice Address - Country:US
Practice Address - Phone:706-896-2289
Practice Address - Fax:706-896-6007
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA006277363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant