Provider Demographics
NPI:1295925402
Name:STANSELL, CHRISTOPHER ALLEN (PA-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:STANSELL
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2700 HIGHWAY 34 E BLDG 300
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1330
Mailing Address - Country:US
Mailing Address - Phone:770-304-0987
Mailing Address - Fax:770-304-0534
Practice Address - Street 1:2700 HIGHWAY 34 E BLDG 300
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1330
Practice Address - Country:US
Practice Address - Phone:770-304-0987
Practice Address - Fax:770-304-0534
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2022-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA5105363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant