Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 077248 | GA |
NPI | 1013126341 |
---|---|
Provider Name | Jarrod D Day |
First Address | Stockbridge, GA 30281-9084 |
Second Address | Stockbridge, GA 30281-9084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 30/09/2020 |