Individual
JORDANA A HEAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 PROFESSIONAL WAY, STE 200, WOODSTOCK, GA 30188
(770) 517-0250
(770) 517-0260
Mailing address
2000 PROFESSIONAL WAY, BLDG 200, WOODSTOCK, GA 30188
(770) 517-0250
(770) 517-0260
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
049697
GA
Other
Enumeration date
06/06/2006
Last updated
10/03/2011
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