Feldman, Jack A
Feldman, Jack A is an individual health care provider with primary practice located at 3623 J Dewey Gray Circle Suite 101, Augusta GA 30909. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Feldman, Jack A can be contacted via phone (706) 868-5057.Contact Information
Primary practice address
3623 J Dewey Gray Circle Suite 101
Augusta GA 30909
Phone: (706) 868-5057
Fax: (706) 855-1244
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 019942 | Georgia |
Profile Details
| NPI number | 1891771150 |
|---|---|
| LBN Legal business name | Feldman, Jack A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2005 |
| Last updated | Aug 20th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891771150 | NPPES |
| Georgia | MEDICAID | 00208535C |
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