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General NPI Number Information
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NPI Number | 1689329476
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Entity Type | Organization
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Legal Business Name | SUPPORTIVE MEDICINE SPECIALISTS, PC
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Dates
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Enumeration Date | 02/20/2022
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 1800 HOWELL MILL RD SUITE 800
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City | ATLANTA
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State | GA
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Zip | 30318
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Country | US
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Telephone | 470-830-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 2870 PEACHTREE RD #364
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City | ATLANTA
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State | GA
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Zip | 30305
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/ PHYSICIAN
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Name | DR. JOSHUA JACKSON
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Credential | MD
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Telephone | 470-830-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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