Provider Demographics
NPI:1265663983
Name:JIAN, JASON MING (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:MING
Last Name:JIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MING
Other - Middle Name:
Other - Last Name:JIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:780 OAK TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-3836
Mailing Address - Country:US
Mailing Address - Phone:205-482-8024
Mailing Address - Fax:
Practice Address - Street 1:100 MARKET PLACE BLVD STE 309
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-8717
Practice Address - Country:US
Practice Address - Phone:470-363-3960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA673352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty