Individual
DR. JEFFREY M. REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
61 WHITCHER STREET NE, SUITE 2100, MARIETTA, GA 30060
(770) 423-0595
(770) 874-1614
Mailing address
100 STONEFOREST DR STE 130, WOODSTOCK, GA 30189-4881
(770) 423-0595
(678) 388-1627
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
047018
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000818925A
—
GA
Enumeration date
08/26/2005
Last updated
04/22/2020
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