MEDICARE: JOHN THOMAS APGAR MD

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	207N00000X	Dermatology Physician	014265	GA

General Provider Information

NPI Number	:	1841308376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN THOMAS APGAR MD

Provider Business Mailing Address
First Line	:	3890 JOHNS CREEK PKWY
Second Line	:	SUITE 320
City	:	SUWANEE
State	:	GA
Zip	:	30024-1284
Country	:	US
Telephone Number	:	770-622-4412
Fax Number	:	770-622-4191

Provider Business Practice Location Address
First Line	:	3890 JOHNS CREEK PKWY
Second Line	:	SUITE 320
City	:	SUWANEE
State	:	GA
Zip	:	30024-1284
Country	:	US
Telephone Number	:	770-622-4412
Fax Number	:	770-622-4191

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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