Individual
JEFFREY THOMAS GARDNER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2383 PATE ST N, SNELLVILLE, GA 30078-3250
(770) 972-4845
(770) 972-0358
Mailing address
2383 PATE ST N, SNELLVILLE, GA 30078-3250
(770) 972-4845
(770) 972-0358
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
101335
GA
207N00000X
Dermatology Physician
4306
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2019
Last updated
10/14/2024
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