Provider Demographics
NPI:1548564784
Name:JOEL L AXLER MD, LLC
Entity Type:Organization
Organization Name:JOEL L AXLER MD, LLC
Other - Org Name:J
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:AXLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-808-8548
Mailing Address - Street 1:2526 MOUNT VERNON RD
Mailing Address - Street 2:SUITE B, #170
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-3049
Mailing Address - Country:US
Mailing Address - Phone:404-808-8548
Mailing Address - Fax:
Practice Address - Street 1:2151 PEACHFORD RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6534
Practice Address - Country:US
Practice Address - Phone:404-808-8548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0353692084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty