MEDICARE: DR. JEFFREY EBERT P.T., D.P.T., O.C.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	2226	NE
2	2251X0800X	Orthopedic Physical Therapist	PT011222	GA

General Provider Information

NPI Number	:	1033265319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY EBERT P.T., D.P.T., O.C.S.

Provider Business Mailing Address
First Line	:	4634 FITZPATRICK WAY
Second Line	:
City	:	PEACHTREE CORNERS
State	:	GA
Zip	:	30092-1004
Country	:	US
Telephone Number	:	402-981-0067
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 MERCER UNIVERSITY DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-4115
Country	:	US
Telephone Number	:	678-547-6549
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	09/28/2015

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