Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 2014018993 | MO |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ME139608 | FL |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 85449 | GA |
NPI | 1851705966 |
---|---|
Provider Name | Dr. Jennifer H Gross |
First Address | Atlanta, GA 30308-2212 |
Second Address | Atlanta, GA 30308-2212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2014 |
Last Update Date | 07/02/2022 |