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NPI Code Detail

MEDICARE: JAY ALAN ERDMAN M.D.

MEDICARE: JAY ALAN ERDMAN 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
1207P00000XEmergency Medicine PhysicianE91398GA

Other Identifiers

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

General Provider Information

NPI Number : 1700874864
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY ALAN ERDMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 5661
Second Line :
City : ATHENS
State : GA
Zip : 30604-5661
Country : US
Telephone Number : 706-354-5770
Fax Number : 706-354-5769
Provider Business Practice Location Address
First Line : 60 HOSPITAL RD
Second Line :
City : NEWNAN
State : GA
Zip : 30263-1210
Country : US
Telephone Number : 800-532-6151
Fax Number : 770-251-7873
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 11/24/2009

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