Organization
ATLANTA DERMATOLOGY & SURGERY P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY LEE COOPER MD (PRESIDENT)
(404) 296-8000
Entity
Organization
Contact information
Practice address
1462 MONTREAL RD, SUITE 411, TUCKER, GA 30084-6929
(404) 296-8000
(770) 493-6842
Mailing address
1462 MONTREAL RD, SUITE 411, TUCKER, GA 30084-6929
(404) 296-8000
(770) 493-6842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
011850
GA
Other
Enumeration date
05/29/2007
Last updated
11/17/2015
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