Provider Demographics
NPI:1235371832
Name:JDONOHUE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:JDONOHUE ENTERPRISES, INC.
Other - Org Name:BODYLOGICMD OR ATLANTA/ BUCKHEAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOHUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-460-3246
Mailing Address - Street 1:403 JUNIPER MILL TRCE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-9601
Mailing Address - Country:US
Mailing Address - Phone:866-460-3246
Mailing Address - Fax:866-510-0145
Practice Address - Street 1:107 W PACES FERRY RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1398
Practice Address - Country:US
Practice Address - Phone:866-460-3246
Practice Address - Fax:866-510-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA46540174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty