Hairston, Jeffrey N

Hairston, Jeffrey N is an individual health care provider with primary practice located at 2041 Mesa Valley Way Suite 100, Austell GA 30106-6828. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Hairston, Jeffrey N can be contacted via phone (770) 944-1100.

Contact Information

Primary practice address
2041 Mesa Valley Way Suite 100 Austell GA 30106-6828
Phone: (770) 944-1100
Fax: (770) 941-7227
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 002922 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002922 Georgia

Profile Details

NPI number 1063625051
LBN Legal business name Hairston, Jeffrey N
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2007
Last updated Jul 11th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063625051 NPPES
Georgia MEDICAID 507133071F
Georgia MEDICAID 507133071E
Georgia MEDICAID 507133071G

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