Provider Demographics
NPI:1235315078
Name:SHORT, JAMIE KEITH (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:KEITH
Last Name:SHORT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2004 RIDGEWOOD DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1031
Mailing Address - Country:US
Mailing Address - Phone:404-727-5157
Mailing Address - Fax:404-727-4746
Practice Address - Street 1:2004 RIDGEWOOD DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1031
Practice Address - Country:US
Practice Address - Phone:404-727-5157
Practice Address - Fax:404-727-4746
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2022-01-07
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Provider Licenses
StateLicense IDTaxonomies
GA0572512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry