Individual
JOSEPH T OVERTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4155 BAKER ST NE, SUITE 100, COVINGTON, GA 30014-1405
(770) 788-0620
(678) 342-3327
Mailing address
PO BOX 945934, ATLANTA, GA 30394-5934
(770) 788-0620
(678) 342-3327
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
038900
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00762308D
—
GA
01
—
0300335
EVERCARE PROVIDER #
GA
01
—
1024502
AETNA HMO PROVIDER #
GA
01
—
4697
KAISER
GA
01
—
5261485
AETNA PPO PROVIDER #
GA
01
—
77159135
WAUSAU PROVIDER #
GA
01
—
953055
BC/BS PROVIDER #
GA
01
—
GA0100
JOHN DEER NONPAR PROV #
GA
Enumeration date
08/30/2006
Last updated
08/30/2010
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