Provider Demographics
NPI:1184685240
Name:SULZER, JANA LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:LEIGH
Last Name:SULZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 PIEDMONT RD NE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1609
Mailing Address - Country:US
Mailing Address - Phone:404-870-2802
Mailing Address - Fax:404-419-6623
Practice Address - Street 1:3520 PIEDMONT RD NE STE 250
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305
Practice Address - Country:US
Practice Address - Phone:404-870-2802
Practice Address - Fax:404-419-6623
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0964412085R0202X
GA0476662085R0202X
FLME45360174400000X
CAG887782085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043904500Medicaid
FL043904500Medicaid
FL14204CMedicare ID - Type Unspecified