Individual
DR. JACOB VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 NORTHSIDE FORSYTH DR OFC, SUITE 350, CUMMING, GA 30041-7668
(404) 365-0966
(770) 650-5589
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
056933
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
987062284B
—
GA
Enumeration date
12/15/2006
Last updated
01/07/2022
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