Healthcare Provider Details

I. General information

NPI: 1699773234
Provider Name (Legal Business Name): JOANNE GILBY BEER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3292 MOUNTAIN DR STE A
DECATUR GA
30032-1102
US

IV. Provider business mailing address

1648 TIMBERLAND RD NE
ATLANTA GA
30345-4165
US

V. Phone/Fax

Practice location:
  • Phone: 404-294-8180
  • Fax: 404-294-8188
Mailing address:
  • Phone: 404-320-1467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number003332
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: