Provider Demographics
NPI:1407000821
Name:TADROS, JOCELYNE SAWERIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOCELYNE
Middle Name:SAWERIS
Last Name:TADROS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOCELYNE
Other - Middle Name:MAGDY
Other - Last Name:SAWERIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:743 SPRING ST NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3715
Practice Address - Country:US
Practice Address - Phone:770-535-3611
Practice Address - Fax:770-535-7092
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA61652208M00000X
GA061652208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA8723262OtherCIGNA
GA558108OtherWELLCARE
GA01348277OtherAMERIGROUP
GA52457195OtherBCBS
GA721175404BMedicaid
GA3180115OtherUHC
GA8723262OtherCIGNA