Provider Demographics
NPI:1083965917
Name:ESHLEMAN, BRANDON LEE (PA-C)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:LEE
Last Name:ESHLEMAN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 ROSWELL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2205
Mailing Address - Country:US
Mailing Address - Phone:404-264-9553
Mailing Address - Fax:404-266-2294
Practice Address - Street 1:5009 ROSWELL RD STE 201
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2205
Practice Address - Country:US
Practice Address - Phone:404-264-9553
Practice Address - Fax:404-266-2294
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
GA006606363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical