Individual
JEFFREY G PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
970 JOE FRANK HARRIS PKWY SE, SUITE 260, CARTERSVILLE, GA 30120-2159
(770) 607-1893
(770) 607-2930
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
043267
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000770888A
—
GA
01
—
340016381
RAILROAD MEDICARE
GA
Enumeration date
09/12/2006
Last updated
03/07/2023
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