Healthcare Provider Details

I. General information

NPI: 1972636652
Provider Name (Legal Business Name): EUGENE ROBERT FERRI JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 09/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2292 PEACHTREE RD NW
ATLANTA GA
30309
US

IV. Provider business mailing address

3927 PINEHURST WAY
DULUTH GA
30096-3172
US

V. Phone/Fax

Practice location:
  • Phone: 404-382-9941
  • Fax: 404-351-6762
Mailing address:
  • Phone: 678-442-3317
  • Fax: 678-442-4416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number026113
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number026113
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: