Healthcare Provider Details

I. General information

NPI: 1538165352
Provider Name (Legal Business Name): ALAN L JOFFE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 12/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

993 JOHNSON FERRY RD NE BLD C STE 120
ATLANTA GA
30342-1620
US

IV. Provider business mailing address

993 JOHNSON FERRY RD NE BLD C STE 120
ATLANTA GA
30342-1620
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-2811
  • Fax: 404-257-9855
Mailing address:
  • Phone: 404-256-2811
  • Fax: 404-257-9855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number021164
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number021164
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number021164
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: