Healthcare Provider Details

I. General information

NPI: 1821051970
Provider Name (Legal Business Name): HARVEY JAY SCHECTER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 KILLIAN HILL RD SW SUITE A
LILBURN GA
30047-3102
US

IV. Provider business mailing address

976 KILLIAN HILL RD SW SUITE A
LILBURN GA
30047-3102
US

V. Phone/Fax

Practice location:
  • Phone: 770-923-7500
  • Fax: 770-923-7502
Mailing address:
  • Phone: 770-923-7500
  • Fax: 770-923-7502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number015982
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: