Individual
DR. JASON ALEXANDER PETROFSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1505 NORTHSIDE BLVD, SUITE 1900, CUMMING, GA 30041-7623
(678) 341-3764
(678) 341-3769
Mailing address
1505 NORTHSIDE BLVD, SUITE 1900, CUMMING, GA 30041-7623
(678) 341-3764
(678) 341-3769
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
059311
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236918506A
—
GA
05
—
236918506D
—
GA
05
—
236918506E
—
GA
Enumeration date
01/30/2007
Last updated
08/10/2020
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