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BRETT DANIEL PUCKETT PA-C MMSC ATC NPI 1265830152


NPI Information

NPI: 1265830152
Provider Name: BRETT DANIEL PUCKETT, PA-C, MMSC, ATC
Classification: Physician Assistant - 363A00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
771 OLD NORCROSS RD STE 390
LAWRENCEVILLE, GA
ZIP 30046
Phone: (678) 957-0757
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Brett Daniel Puckett, PA-C, MMSC, ATC is a physician assistant in Lawrenceville, GA with 4 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Brett Daniel Puckett, PA-C, MMSC, ATC NPI is 1265830152. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2020

The provider's business location address is:

771 OLD NORCROSS RD STE 390
LAWRENCEVILLE, GA
ZIP 30046-324
Phone: (678) 957-0757
Fax: (678) 957-9597

The NPI 1265830152 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/9/2014 and was last updated on 11/15/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12255A2300XSpecialist/TechnologistAthletic Trainer36002274AINDIANANo
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
3363A00000XPhysician Assistant10254GEORGIAYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.