Individual
JOHN C JAQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2335 LIMESTONE OVERLOOK, GAINESVILLE, GA 30501-7443
(770) 297-0356
(770) 297-7564
Mailing address
3525 PIEDMONT ROAD NE, #7-601, ATLANTA, GA 30305-7041
(404) 842-5425
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001966
GA
Other
Enumeration date
03/10/2006
Last updated
01/26/2012
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