MEDICARE: MICHAEL JONATHAN YORK M.D.

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	207X00000X	Orthopaedic Surgery Physician	032331	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0486290001	OTHER		DME

General Provider Information

NPI Number	:	1407858434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JONATHAN YORK M.D.

Provider Business Mailing Address
First Line	:	2001 PEACHTREE RD NE
Second Line	:	SUITE 705
City	:	ATLANTA
State	:	GA
Zip	:	30309-1476
Country	:	US
Telephone Number	:	404-355-0743
Fax Number	:	404-355-2136

Provider Business Practice Location Address
First Line	:	1901 PHOENIX BLVD
Second Line	:	STE 200
City	:	COLLEGE PARK
State	:	GA
Zip	:	30349-5588
Country	:	US
Telephone Number	:	404-355-0743
Fax Number	:	770-991-6477

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/21/2010

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