PETER VERNON EDBLAD PA-C NPI 1689554032

NPI Information

  • NPI: 1689554032
  • Provider Name: PETER VERNON EDBLAD, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 655 JESSE JEWELL PKWY SE
    GAINESVILLE, GA
    ZIP 30501
  • Phone: (770) 532-7092

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NPI Details

Peter Vernon Edblad, PA-C is a surgical physician assistant in Gainesville, GA. Peter Vernon Edblad, PA-C NPI is 1689554032. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

655 JESSE JEWELL PKWY SE
GAINESVILLE, GA
ZIP 30501-756
Phone: (770) 532-7092
Fax: (770) 534-8145

The NPI 1689554032 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 9/5/2025 and was last updated on 11/18/2025.

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
1363A00000XPhysician AssistantGEORGIANo
2363AS0400XPhysician AssistantSurgical13447GEORGIAYes

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
11689554032OTHERGEORGIANPI

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: 11/21/2025

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