Provider Demographics
NPI:1770698904
Name:WINBORNE, SONYA (PAC)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:WINBORNE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:525 WESTPARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1575
Mailing Address - Country:US
Mailing Address - Phone:770-716-2680
Mailing Address - Fax:770-716-2681
Practice Address - Street 1:525 WESTPARK DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30214-4549
Practice Address - Country:US
Practice Address - Phone:770-716-2680
Practice Address - Fax:770-716-2681
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA002146363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant