Provider Demographics
NPI:1952751646
Name:LABAR, ANN HALL (PA-C)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:HALL
Last Name:LABAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 KING ARNOLD DR.
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354
Mailing Address - Country:US
Mailing Address - Phone:404-915-1685
Mailing Address - Fax:
Practice Address - Street 1:411 KING ARNOLD ST
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1613
Practice Address - Country:US
Practice Address - Phone:404-915-1685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2485363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant