Individual
JERMAINE FREDERICK TAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 WHITCHER ST NE STE 250, MARIETTA, GA 30060-1169
(770) 428-4475
(770) 489-1589
Mailing address
55 WHITCHER STREET 250, MARIETTA, GA 30060-3812
(770) 428-4475
(770) 489-1589
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004054
GA
Other
Enumeration date
02/06/2007
Last updated
11/06/2019
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