Provider Demographics
NPI:1215123930
Name:BOYTER, ELIZABETH HASLEY (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HASLEY
Last Name:BOYTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1110 W PEACHTREE ST NW STE 1100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3609
Mailing Address - Country:US
Mailing Address - Phone:404-892-2131
Mailing Address - Fax:404-215-9222
Practice Address - Street 1:1110 W PEACHTREE ST NW STE 1100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3609
Practice Address - Country:US
Practice Address - Phone:404-892-2131
Practice Address - Fax:404-215-9222
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA005076363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical