Healthcare Provider Details

I. General information

NPI: 1649615584
Provider Name (Legal Business Name): NJ MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 THOMPSON BRIDGE RD
GAINESVILLE GA
30501-1704
US

IV. Provider business mailing address

1016 THOMPSON BRIDGE RD
GAINESVILLE GA
30501-1704
US

V. Phone/Fax

Practice location:
  • Phone: 678-450-1222
  • Fax: 678-450-1224
Mailing address:
  • Phone: 678-450-1222
  • Fax: 678-450-1224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALVIS T PERRY
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 678-450-1222