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Jeffrey Thomas Gardner II

Dermatology in Snellville, GA. Individual provider (NPI-1).

NPI number1366901324
StatusActive
Last updated in NPPESOct 14, 2024

Details

NPI
1366901324
Entity type
Individual (NPI-1)
Name
Jeffrey Thomas Gardner II
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 18, 2019
Certification date
Oct 10, 2024
Last updated
Oct 14, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatology101335GAYes
207N00000X Dermatology4306CA
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

2383 Pate St N
Snellville, GA 30078-3250

Phone 770-972-4845 · Fax 770-972-0358

Mailing address

2383 Pate St N
Snellville, GA 30078-3250

Phone 770-972-4845 · Fax 770-972-0358

Other practice locations

55 Fruit St
Boston, MA 02114

Phone 617-726-2000

1250 E 66th St
Savannah, GA 31404-5704

Phone 800-637-2378

55 Fruit St
Boston, MA 02114

Phone 617-726-2000

11234 Anderson St # C
Loma Linda, CA 92354-2804

Phone 909-558-2890

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