Individual
JEAN GERALD NOUGAISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3400 MCCLURE BRIDGE RD BLDG B, DULUTH, GA 30096-6675
(678) 957-8801
(678) 957-8804
Mailing address
2512 KELMAN PL, DACULA, GA 30019-7099
(770) 277-2424
(770) 277-2424
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
004761
GA
363AS0400X
Surgical Physician Assistant
005668
NY
Other
Enumeration date
04/12/2006
Last updated
03/21/2012
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