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NPI Code Detail

MEDICARE: DR. JAY B STALLMAN M.D.

MEDICARE: DR. JAY B STALLMAN 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
1207W00000XOphthalmology Physician041004GA

General Provider Information

NPI Number : 1457354607
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY B STALLMAN M.D.
Provider Business Mailing Address
First Line : 1100 JOHNSON FERRY RD NE
Second Line : SUITE 593
City : ATLANTA
State : GA
Zip : 30342-1709
Country : US
Telephone Number : 404-255-9096
Fax Number : 404-255-9097
Provider Business Practice Location Address
First Line : 1100 JOHNSON FERRY RD NE
Second Line : SUITE 593
City : ATLANTA
State : GA
Zip : 30342-1709
Country : US
Telephone Number : 404-255-9096
Fax Number : 404-255-9097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 02/12/2010

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Directions to “ DR. JAY B STALLMAN M.D.” Practice Location

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