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:
Health care specialties
| Specialty | Code | License # | 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 6 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 | 1568508893 | NPPES |
| Georgia | MEDICAID | 236918506A | |
| Georgia | MEDICAID | 236918506E | |
| Georgia | MEDICAID | 236918506D |
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