Provider Demographics
NPI:1003320433
Name:SWAIN, KRYSTLE WILLIAMS (PA-C)
Entity type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:WILLIAMS
Last Name:SWAIN
Suffix:
Gender:F
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 1:3320 OLD JEFFERSON RD BLDG 800
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-1400
Mailing Address - Country:US
Mailing Address - Phone:706-353-2990
Mailing Address - Fax:706-353-2992
Practice Address - Street 1:3320 OLD JEFFERSON RD STE 600
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-1463
Practice Address - Country:US
Practice Address - Phone:762-356-4933
Practice Address - Fax:762-356-4034
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8576363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical