Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth C. Holbrook, PA

Individual provider Physician Assistant · NPI 1194790139

Kenneth C. Holbrook, PA is a Physician Assistant in Austell, Georgia. Graduated from Medical College of Georgia School of Medicine in 2002, 24 years ago. Practices with Resurgens, LLC, a 182-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
24
Trained at
Medical College of Georgia School of Medicine
Licensed in
GA
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2041 Mesa Valley Way Ste 100
Austell, GA 30106-6828
Phone: (770) 944-1100
Fax: (770) 944-6469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 003877 (GA)

Record details

NPI number1194790139
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 22, 2006
Last updated in NPPESMay 20, 2011
Mailing address2041 Mesa Valley Way, Suite 100, Austell, GA 30106-6828

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Resurgens, Llc — 182 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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