Individual
JATANDRA ANISE MORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-1000
Mailing address
404 DAKER DR, PEACHTREE CITY, GA 30269-1535
(225) 772-5819
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
309965
LA
207L00000X
Anesthesiology Physician
84902
GA
207L00000X
Anesthesiology Physician
BP10046231
TX
207LP3000X
Pediatric Anesthesiology Physician
35.143554
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0469362
—
OH
Enumeration date
04/22/2013
Last updated
04/09/2025
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