Individual
DR. BENNETT J. AXELROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MEDICAL CENTER BLVD, SUITE 100, LAWRENCEVILLE, GA 30045-8708
(770) 682-6000
(770) 513-1103
Mailing address
4055 JOHNS CREEK PKWY, STE. A, SUWANEE, GA 30024-1299
(678) 957-3040
(678) 957-3047
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
026442
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00335926B
—
GA
Enumeration date
05/05/2006
Last updated
03/07/2023
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