James, Jack Donald
James, Jack Donald is an individual health care provider with primary practice located at 1380 Milstead Ave Ne Suite B, Conyers GA 30012-3864. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. James, Jack Donald can be contacted via phone (770) 760-7007.Contact Information
Primary practice address
1380 Milstead Ave Ne Suite B
Conyers GA 30012-3864
Phone: (770) 760-7007
Fax: (770) 760-7611
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 015479 | Georgia |
Profile Details
| NPI number | 1609845403 |
|---|---|
| LBN Legal business name | James, Jack Donald |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1609845403 | NPPES |
| Georgia | MEDICAID | 00155284D |
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