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Kathryn Jalal Bauman

Physician Assistant in Decatur, GA. Individual provider (NPI-1).

NPI number1083852016
StatusActive
Last updated in NPPESJul 11, 2024

Details

NPI
1083852016
Entity type
Individual (NPI-1)
Name
Mrs. Kathryn Jalal Bauman
Sex
Female
Sole proprietor
No
Enumeration date
Jan 29, 2009
Certification date
Sep 23, 2021
Last updated
Jul 11, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant11501GAYes

Other names

  • Kathryn Jalal Smith (Former Name)

Practice location

1670 Clairmont Rd
Decatur, GA 30033-4004

Phone 919-636-2709

Mailing address

162 Mead Rd
Decatur, GA 30030-3621

Phone 919-636-2709

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