Provider Demographics
NPI:1437257748
Name:WEST, JOHN ELLIOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ELLIOTT
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1800 TREE LN
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2016
Mailing Address - Country:US
Mailing Address - Phone:770-972-4871
Mailing Address - Fax:770-979-3782
Practice Address - Street 1:1800 TREE LN
Practice Address - Street 2:SUITE 250
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2016
Practice Address - Country:US
Practice Address - Phone:770-972-4871
Practice Address - Fax:770-979-3782
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-06-26
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Provider Licenses
StateLicense IDTaxonomies
GA028915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE-19906Medicare UPIN
GA08BDFTHMedicare ID - Type Unspecified