Individual
DR. MITCHELL JABLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3641 CLUBLAND DR, MARIETTA, GA 30068-4003
(770) 757-3220
(770) 971-2996
Mailing address
3641 CLUBLAND DR, MARIETTA, GA 30068-4003
(770) 757-3220
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13399
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13399
STATE OF GA MEDICAL BOARD
GA
Enumeration date
11/25/2013
Last updated
11/25/2013
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