Healthcare Provider Details

I. General information

NPI: 1609230341
Provider Name (Legal Business Name): ALANA DAIVA JASPER-TROTTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALANA DAIVA TROTTER MD

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6133 PEACHTREE DUNWOODY RD
SANDY SPRINGS GA
30328-5332
US

IV. Provider business mailing address

6133 PEACHTREE DUNWOODY RD
SANDY SPRINGS GA
30328-5332
US

V. Phone/Fax

Practice location:
  • Phone: 678-412-0311
  • Fax:
Mailing address:
  • Phone: 678-412-0311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2020-00350
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number101758
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number348107
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number101758
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: