Individual
DR. JAQUELIN SMITH GOTLIEB
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5405 MEMORIAL DR, BUILDING D, STONE MOUNTAIN, GA 30083-3234
(404) 296-3800
(404) 297-8753
Mailing address
5405 MEMORIAL DR, BUILDING D, STONE MOUNTAIN, GA 30083-3234
(404) 296-3800
(404) 297-8753
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
017810
GA
Other
Enumeration date
07/12/2005
Last updated
07/08/2007
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