Individual
ENOE J JIMENEZ CORDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST # BI-2144, AUGUSTA, GA 30912-0004
(706) 721-3871
Mailing address
1120 15TH ST # BI-2144, AUGUSTA, GA 30912-0004
(706) 721-7753
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
11960
GA
207L00000X
Anesthesiology Physician
E-19101
AR
207LP3000X
Pediatric Anesthesiology Physician
Primary
E-19101
AR
Other
Enumeration date
06/10/2020
Last updated
07/02/2025
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