MEDICARE: JEFFREY SCOTT DURMER MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	052711	GA
2	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	052711	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275598724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY SCOTT DURMER MD, PHD

Provider Business Mailing Address
First Line	:	5000 RESEARCH COURT
Second Line	:	SUITE A
City	:	SUWANEE
State	:	GA
Zip	:	30024-6660
Country	:	US
Telephone Number	:	678-990-3962
Fax Number	:	678-840-3777

Provider Business Practice Location Address
First Line	:	4245 JOHNS CREEK PKWY
Second Line	:	SUITE A
City	:	SUWANEE
State	:	GA
Zip	:	30024-9122
Country	:	US
Telephone Number	:	678-990-3962
Fax Number	:	678-840-3777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	06/26/2020

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