Individual
DR. JACOB NATHAN BLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 HOSPITAL SOUTH DR, SUITE 409, AUSTELL, GA 30106-6810
(770) 424-6893
(770) 528-9926
Mailing address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(770) 528-9926
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
057935
GA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
057935
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
859089115A
—
GA
05
—
859089115B
—
GA
05
—
859089115C
—
GA
05
—
859089115D
—
GA
Enumeration date
01/31/2008
Last updated
11/15/2019
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