MEDICARE: JOSE LUIS FERNANDEZ M.D.

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	207R00000X	Internal Medicine Physician	038483	GA

General Provider Information

NPI Number	:	1487641627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE LUIS FERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	530 CITY PARK DR
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30252-1021
Country	:	US
Telephone Number	:	770-317-6312
Fax Number	:	770-506-4368

Provider Business Practice Location Address
First Line	:	2201 TALMADGE RD
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228-1608
Country	:	US
Telephone Number	:	678-479-1234
Fax Number	:	678-479-5678

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

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	08/28/2007

Similar Medicare Providers

1962529529 — SOUTHSIDE MEDICAL CENTER, INC.
Practice Location Address:

2201 TALMADGE RD
HAMPTON, GA
30228-1608

Practice Phone: 678-593-4666
Practice Fax:

1558583658 — OBIAJULU C. OKAFOR M.D.
Practice Location Address:

2201 TALMADGE RD
HAMPTON, GA
30228-1608

Practice Phone: 678-593-4666
Practice Fax: 678-593-4665

1336793710 — MRS. SHANICE THURMOND PA-C
Practice Location Address:

2201 TALMADGE RD
HAMPTON, GA
30228-1608

Practice Phone: 404-564-7005
Practice Fax:

1467311837 — JACQKENIA WILLIAMS
Practice Location Address:

2201 TALMADGE RD
HAMPTON, GA
30228-1608

Practice Phone: 352-575-8483
Practice Fax:

1780214262 — JADA BLAKELY LPN
Practice Location Address:

184 S HAMPTON RD
COLUMBUS, OH
43213-1608

Practice Phone: 614-942-9146
Practice Fax:

1225854243 — MRS. ASHLEY H WALLACE ED.S, LAPC, NCC
Practice Location Address:

10745 MISTY MEADOWS CT
HAMPTON, GA
30228-6162

Practice Phone: 470-516-1229
Practice Fax:

Directions to “ JOSE LUIS FERNANDEZ M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.