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Individual

JASON BARRY LICHTENSTEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(678) 216-0771
Mailing address
5315 LONDON DR, ATLANTA, GA 30327-4943
(404) 772-1787

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
62058
GA
207L00000X
Anesthesiology Physician
A77296
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A772960
CA
Enumeration date
06/22/2006
Last updated
01/24/2023
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