MEDICARE: JANE R FURTNER INC

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	1041C0700X	Clinical Social Worker	CSW001270	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

General Provider Information

NPI Number	:	1689806002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANE R FURTNER INC

Provider Business Mailing Address
First Line	:	4481 PINERIDGE CIR
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-6540
Country	:	US
Telephone Number	:	770-825-0448
Fax Number	:	770-451-9731

Provider Business Practice Location Address
First Line	:	6755 PEACHTREE INDUSTRIAL BLVD
Second Line	:	STE 110
City	:	ATLANTA
State	:	GA
Zip	:	30360-2223
Country	:	US
Telephone Number	:	770-825-0448
Fax Number	:	770-451-9731

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JANE R FURTNER
Credential	:	LCSW
Telephone Number	:	770-825-0448

Provider Enumeration Date	:	08/18/2009
Last Update Date	:	08/18/2009

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Directions to “JANE R FURTNER INC ” Practice Location

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