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Mrs. Kathy S Poodiack, PA-C
Medical Physician Assistant in Austell, Georgia
NPI 1700030624

Kathy S Poodiack is a Medical Physician Assistant based in Austell, GA and is specialized in Medical. Kathy S Poodiack practices in Austell, GA and has the professional credentials of PA-C. The NPI Number for Kathy S Poodiack is 1700030624 and holds a License No. PA9104850 (Georgia).

The current practice location address for Kathy S Poodiack is 1700 Hospital South Drive, Austell, GA and can be reached out via phone at 770-944-2830 and via fax at 678-581-7170.

Location: 1700 Hospital South Drive, Austell, GA, 30106-8116
person
Provider Profile Details
NPI Number
1700030624
Provider Name
Kathy S Poodiack
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
1700 Hospital South Drive, Austell, GA, 30106-8116
Phone Number
770-944-2830
Fax Number
678-581-7170
Provider Enumeration Date
11/05/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
002325 01 GA STATE MEDICAL LICENSE
GRP245 01 GA MEDICARE, GROUP NUMBER
institution
Provider Business Practice Location Address Details
Address
1700 Hospital South Drive
City
State
Zip
30106-8116
Phone Number
770-944-2830
Fax Number
678-581-7170
person
Provider Business Mailing Address Details
Address
1700 Hospital South Drive
City
State
Zip
30106-8116
Phone Number
770-944-2830
Fax Number
678-581-7170
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA9104850 (Florida)
Definition
Definition to come...
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