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Individual

ANNANTA JACKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4200 NORTHSIDE PKWY NW BLDG 8, ATLANTA, GA 30327-3007
(404) 881-8020
Mailing address
4200 NORTHSIDE PKWY NW BLDG 8, ATLANTA, GA 30327-3007

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7696
GA

Other

Enumeration date
08/19/2016
Last updated
08/19/2016
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