MEDICARE: DR. JAY JEFFREY D'LUGIN 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	207P00000X	Emergency Medicine Physician	54482	NC
2	207P00000X	Emergency Medicine Physician	G84787	CA
3	207P00000X	Emergency Medicine Physician	47891	GA
4	207R00000X	Internal Medicine Physician	047891	GA

General Provider Information

NPI Number	:	1851581557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY JEFFREY D'LUGIN MD

Provider Business Mailing Address
First Line	:	1421 PEACHTREE ST NE STE 503
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-3015
Country	:	US
Telephone Number	:	404-567-6546
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 PEACHTREE ST NE STE 503
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-3015
Country	:	US
Telephone Number	:	404-567-6546
Fax Number	:

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

Provider Enumeration Date	:	07/28/2007
Last Update Date	:	03/08/2023

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