Provider Demographics
NPI:1497644785
Name:MAXWELL, JONATHAN (PA-C)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:MAXWELL
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:12300 APACHE AVE APT 1209
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-2340
Mailing Address - Country:US
Mailing Address - Phone:404-310-3669
Mailing Address - Fax:
Practice Address - Street 1:1700 HOSPITAL SOUTH DR STE 502
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-8159
Practice Address - Country:US
Practice Address - Phone:943-202-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant