DUANE L PRICKETT SA-C RSA LSA NPI 1215084959

NPI Information

NPI: 1215084959
Provider Name: DUANE L PRICKETT, SA-C, RSA, LSA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
1579 MONROE DR NE STE F
ATLANTA, GA
ZIP 30324
Phone: (404) 788-1321
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Duane L Prickett, SA-C, RSA, LSA is a surgical physician assistant in Atlanta, GA. Duane L Prickett, SA-C, RSA, LSA NPI is 1215084959. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1579 MONROE DR NE STE F
ATLANTA, GA
ZIP 30324-022
Phone: (404) 788-1321

The enumeration date for this NPI number is 1/4/2007 and was last updated on 12/5/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246ZC0007X	Specialist/Technologist, Other	Surgical Assistant	02-151	GEORGIA	No
2	363AS0400X	Physician Assistant	Surgical		GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02-151	OTHER		SURGICAL ASSISTANT-CERTIFIED
2	238.000307	OTHER	ILLINOIS	REGISTRATION
3	SA.0001689	OTHER	COLORADO	COLORADO STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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