Individual
DR. JERRY TEE TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 RIDENOUR BLVD NW STE 300, KENNESAW, GA 30152-4402
(770) 634-4215
Mailing address
3999 MATTY DR NE, MARIETTA, GA 30066-1113
(770) 634-4215
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
76501
GA
207L00000X
Anesthesiology Physician
MD.35302
AL
Other
Enumeration date
03/31/2012
Last updated
03/22/2020
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