Provider Demographics
NPI:1295576031
Name:BROOKS, ASHLEY (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 TOWN CREEK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:TALKING ROCK
Mailing Address - State:GA
Mailing Address - Zip Code:30175-2527
Mailing Address - Country:US
Mailing Address - Phone:561-358-5996
Mailing Address - Fax:
Practice Address - Street 1:1700 HOSPITAL SOUTH DR STE 202
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-8116
Practice Address - Country:US
Practice Address - Phone:561-358-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant