Petrofski, Jason Alexander

Petrofski, Jason Alexander is an individual health care provider with primary practice located at 1505 Northside Blvd Suite 1900, Cumming GA 30041-7623. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Petrofski, Jason Alexander can be contacted via phone (678) 341-3764.

Contact Information

Primary practice address
1505 Northside Blvd Suite 1900 Cumming GA 30041-7623
Phone: (678) 341-3764
Fax: (678) 341-3769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 059311 Georgia

Profile Details

NPI number 1568508893
LBN Legal business name Petrofski, Jason Alexander
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Aug 10th, 2020 - about 5 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 1568508893 NPPES
Georgia MEDICAID 236918506A
Georgia MEDICAID 236918506E
Georgia MEDICAID 236918506D

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