Healthcare Provider Details

I. General information

NPI: 1770542094
Provider Name (Legal Business Name): JAY ALAN HOCHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

993-D JOHNSON FERRY RD STE 440
ATLANTA GA
30342-1620
US

IV. Provider business mailing address

993-D JOHNSON FERRY RD STE 440
ATLANTA GA
30342
US

V. Phone/Fax

Practice location:
  • Phone: 404-257-0799
  • Fax: 404-503-2280
Mailing address:
  • Phone: 404-257-0799
  • Fax: 404-503-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number043959
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: