Individual
DR. JENSON T MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
367 CLEAR CREEK PKWY, LAVONIA, GA 30553-4173
(912) 584-9416
Mailing address
3085 SCARLET OAK PASS, CUMMING, GA 30041-1648
(912) 584-9416
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10952
GA
207Q00000X
Family Medicine Physician
Primary
91384
GA
208M00000X
Hospitalist Physician
91384
GA
Other
Enumeration date
05/28/2019
Last updated
04/23/2024
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