Provider Demographics
NPI:1124382569
Name:CUMMINGS, JEWEL M (OTD OTR/L)
Entity Type:Individual
Prefix:DR
First Name:JEWEL
Middle Name:M
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:OTD OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SUTTLES DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-9303
Mailing Address - Country:US
Mailing Address - Phone:404-626-3680
Mailing Address - Fax:404-344-8444
Practice Address - Street 1:6600 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-6773
Practice Address - Country:US
Practice Address - Phone:404-626-3680
Practice Address - Fax:404-244-8444
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1020174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist