Holbrook, Kenneth C.

Holbrook, Kenneth C. is an individual health care provider with primary practice located at 2041 Mesa Valley Way Suite 100, Austell GA 30106-6828. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Holbrook, Kenneth C. 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) 944-6469
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003877 Georgia

Profile Details

NPI number 1194790139
LBN Legal business name Holbrook, Kenneth C.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated May 20th, 2011 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1194790139 NPPES
Georgia MEDICAID 000150059B
Georgia MEDICAID 100002161B
Georgia MEDICAID 000150059C

Popular Providers