Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 054122 | GA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 054122 | GA |
NPI | 1124016910 |
---|---|
Provider Name | Dr. Jason A. Schneider |
First Address | Roswell, GA 30076-5720 |
Second Address | Roswell, GA 30076-5720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 11/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I04562 | (02) | GA |