Provider Demographics
NPI:1477541316
Name:JUST, JOHN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:JUST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-4224
Mailing Address - Country:US
Mailing Address - Phone:256-549-0650
Mailing Address - Fax:256-549-0958
Practice Address - Street 1:310 S 5TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4224
Practice Address - Country:US
Practice Address - Phone:256-549-0650
Practice Address - Fax:256-549-0958
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL102062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0515164149JUSMedicare ID - Type UnspecifiedMEDICARE/GADSDEN OFFICE
ALF27828Medicare UPIN