Provider Demographics
NPI:1457062796
Name:WORMER, JAY (PA)
Entity Type:Individual
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First Name:JAY
Middle Name:
Last Name:WORMER
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Gender:M
Credentials:PA
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Mailing Address - Street 1:900 CIRCLE 75 PKWY SE STE 1700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3087
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:770-953-6972
Practice Address - Street 1:2201 NEWNAN CROSSING BLVD E STE 100
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2551
Practice Address - Country:US
Practice Address - Phone:770-460-4747
Practice Address - Fax:678-673-5102
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant