Provider Demographics
NPI:1578512570
Name:DION, JACQUES E (MD)
Entity Type:Individual
Prefix:
First Name:JACQUES
Middle Name:E
Last Name:DION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1364 CLIFTON RD NE
Mailing Address - Street 2:ROOM A121 DEPT OF RADIOLOGY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-712-4991
Mailing Address - Fax:404-712-0293
Practice Address - Street 1:1364 CLIFTON RD NE
Practice Address - Street 2:ROOM A121 DEPT OF RADIOLOGY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-712-4991
Practice Address - Fax:404-712-0293
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0452012085N0904X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Not Answered2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E84939Medicare UPIN