Individual
WISNA JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1700 HOSPITAL SOUTH DR STE 402, AUSTELL, GA 30106-8116
(770) 739-8282
(770) 739-0794
Mailing address
1700 HOSPITAL SOUTH DR STE 402, AUSTELL, GA 30106-8116
(770) 739-8282
(770) 739-0794
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT201952
PA
207RI0200X
Infectious Disease Physician
Primary
92010
GA
207RI0200X
Infectious Disease Physician
D83759
MD
Other
Enumeration date
06/18/2012
Last updated
11/14/2022
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