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General NPI Number Information
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NPI Number | 1548564784
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Entity Type | Organization
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Legal Business Name | JOEL L AXLER MD, LLC
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 2151 PEACHFORD RD
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City | ATLANTA
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State | GA
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Zip | 30338-6534
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Country | US
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Telephone | 404-808-8548
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Fax |
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Provider Business Mailing Address
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Address Line | 2526 MOUNT VERNON RD SUITE B, #170
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City | ATLANTA
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State | GA
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Zip | 30338-3049
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Country | US
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Telephone | 404-808-8548
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOEL LEE AXLER
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Credential | MD
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Telephone | 404-808-8548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 035369
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License Number State | GA
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