Provider Demographics
NPI:1063480861
Name:DRESSANDER, JEFFRY (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFRY
Middle Name:
Last Name:DRESSANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11650 ALPHARETTA HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076
Mailing Address - Country:US
Mailing Address - Phone:404-596-5670
Mailing Address - Fax:707-338-9103
Practice Address - Street 1:11650 ALPHARETTA HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076
Practice Address - Country:US
Practice Address - Phone:404-596-5670
Practice Address - Fax:404-480-3955
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005032617207X00000X
GA061844207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA878541993AMedicaid
GA878541993AMedicaid
H68846Medicare UPIN
MO787E230Medicare ID - Type Unspecified