Healthcare Provider Details

I. General information

NPI: 1851445274
Provider Name (Legal Business Name): DENISE JAMIESON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 JESSE HILL JR DR SE ROOM 412 GLENN BUILDING
ATLANTA GA
30303-3033
US

IV. Provider business mailing address

4770 BUFORD HWY MAILSTOP K-34
ATLANTA GA
30341-3717
US

V. Phone/Fax

Practice location:
  • Phone: 404-616-3540
  • Fax:
Mailing address:
  • Phone: 770-488-6377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number043968
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: