Provider Demographics
NPI:1396412110
Name:ESCAMILLA MARTINEZ, ALEJANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:ESCAMILLA MARTINEZ
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 1:3333 RIVERWOOD PKWY SE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3304
Mailing Address - Country:US
Mailing Address - Phone:770-914-0116
Mailing Address - Fax:770-955-4278
Practice Address - Street 1:205 DAWSON VILLAGE WAY S
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-5624
Practice Address - Country:US
Practice Address - Phone:770-268-4360
Practice Address - Fax:470-251-6066
Is Sole Proprietor?:No
Enumeration Date:2021-08-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA11652363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant