Provider Demographics
NPI:1164420386
Name:JOSE, JAMES H (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:JOSE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5901 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE B 420
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5382
Mailing Address - Country:US
Mailing Address - Phone:404-252-9751
Mailing Address - Fax:678-990-5763
Practice Address - Street 1:5901 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE B 420
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5382
Practice Address - Country:US
Practice Address - Phone:404-252-9751
Practice Address - Fax:678-990-5763
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2011-04-13
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Provider Licenses
StateLicense IDTaxonomies
GA0265682080N0001X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00293114AMedicaid
GA000293114CMedicaid
GA000293114DMedicaid