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General NPI Number Information
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NPI Number | 1528308814
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Entity Type | Individual
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Provider Name | JASON M FELD M.C.D., CCC-A
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Gender | Male
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Dates
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Enumeration Date | 02/22/2013
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 580 E CROSSVILLE RD STE 340
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City | ROSWELL
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State | GA
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Zip | 30075-3361
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Country | US
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Telephone | 678-352-1940
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Fax |
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Provider Business Mailing Address
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Address Line | 2746 OLD MILL TRL
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City | MARIETTA
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State | GA
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Zip | 30062-5609
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Country | US
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Telephone | 770-650-4486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD003723
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License Number State | GA
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