Black, Judson Gregory

Black, Judson Gregory is an sole proprietor health care provider with primary practice located at 755 Mount Vernon Hwy Ne Ste 430 , Sandy Springs GA 30328-4279. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Black, Judson Gregory can be contacted via phone (404) 303-9945.

Contact Information

Primary practice address
755 Mount Vernon Hwy Ne Ste 430 Sandy Springs GA 30328-4279
Fax: (404) 303-8257
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 017131 Georgia

Profile Details

NPI number 1558468728
LBN Legal business name Black, Judson Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2006
Last updated Aug 1st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558468728 NPPES
Georgia Other 58-2532446 TAX ID

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