Individual
MR. JACK ALEXANDER VAGADORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
URBAN LIFE BUILDING, 11TH FLOOR, 140 DECATUR STREET, ATLANTA, GA 30303-3083
(404) 413-6200
Mailing address
URBAN LIFE BUILDING, 11TH FLOOR, 140 DECATUR STREET, ATLANTA, GA 30303
(404) 413-6200
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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