| Georgia Mountain Endocrinology Corporation | |
|
120 Oakside Ct Suite H Canton GA 30114-2471 | |
| (404) 556-9696 | |
| Not Available |
| Full Name | Georgia Mountain Endocrinology Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 120 Oakside Ct, Canton, Georgia |
| Authorized Official Name and Position | Jason Berner (PRESIDENT) |
| Authorized Official Contact | 4045569696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Mountain Endocrinology Corporation 120 Oakside Ct Suite H Canton GA 30114-2471 Ph: (404) 556-9696 | Georgia Mountain Endocrinology Corporation 120 Oakside Ct Suite H Canton GA 30114-2471 Ph: (404) 556-9696 |
| NPI Number | 1508188558 |
|---|---|
| Provider Enumeration Date | 02/18/2010 |
| Last Update Date | 02/18/2010 |
| Medicare PECOS PAC ID | 7214066075 |
|---|---|
| Medicare Enrollment ID | O20100603000781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508188558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 048322 (Georgia) | Primary |
| Provider Name | Jason A. Berner |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1144201781 PECOS PAC ID: 0143228593 Enrollment ID: I20061117000428 |
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