Individual
DR. JENSIL PHILIP DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1700 TREE LN STE 190, SNELLVILLE, GA 30078-6766
(470) 387-3010
Mailing address
20 WOLVERTON CT, STONE MOUNTAIN, GA 30087-2514
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
80429
GA
207Q00000X
Family Medicine Physician
OS018894
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DRPHIL1989
—
PA
Enumeration date
04/15/2014
Last updated
12/10/2024
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