Tyler Jay Denmeade, PA-C
Physician Assistant in Lawrenceville, GA. Individual provider (NPI-1).
NPI number1669956249
StatusActive
Last updated in NPPESSep 20, 2018
Details
- NPI
- 1669956249
- Entity type
- Individual (NPI-1)
- Name
- Tyler Jay Denmeade
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 20, 2018
- Last updated
- Sep 20, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 008969 | GA | Yes |
Practice location
600 Professional Dr Ste 120Lawrenceville, GA 30046-7638
Phone 770-740-1860 · Fax 678-347-2104
Mailing address
925 N Point Pkwy Ste 130Alpharetta, GA 30005-5211
Phone 770-740-1860 · Fax 678-347-2104
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