Individual
JANEANNA SHELL HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
225 HAWTHORNE PARK, ATHENS, GA 30606-2151
(706) 613-6136
Mailing address
225 HAWTHORNE PARK, ATHENS, GA 30606-2151
(706) 613-6136
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
89465
GA
208000000X
Pediatrics Physician
T-3429
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003254040B
—
GA
Enumeration date
03/24/2017
Last updated
03/22/2022
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