Jennifer R. Pedersen
Endocrinologist (Diabetes Doctor)
4321 University Pkwy Ste 101
Evans
, Georgia 30809
Jennifer R. Pedersen
Endocrinologist (Diabetes Doctor)
4321 University Pkwy Ste 101
Evans
, Georgia 30809
(706) 774-7766
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About
Features
Specialties
- Endocrinologist (Diabetes Doctor)
Languages spoken
- English
Location
First Address
- Jennifer R. Pedersen
- Po Box 1705
- Augusta, GA
- Zip : 30903-1705
- Fax : (706) 774-7766
- Phone : (706) 774-7760
Second Address
- Jennifer R. Pedersen
- 4321 University Pkwy Ste 101
- Evans, GA
- Zip : 30809
- Fax : (706) 774-5996
- Phone : (706) 774-5995
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 052616 | GA |
National Provider Identifier
| NPI | 1073606661 |
|---|---|
| Provider Name | Jennifer R. Pedersen |
| First Address | Augusta, GA 30903-1705 |
| Second Address | Evans, GA 30809 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/10/2006 |
| Last Update Date | 17/10/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000957932B | (05) | GA |
| G52616 | (05) | SC |
| H54829 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.