Provider Demographics
NPI:1679816458
Name:CHRISTENBURY, JOSEPH GILL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GILL
Last Name:CHRISTENBURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 CUMBERLAND BLVD SE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6407
Mailing Address - Country:US
Mailing Address - Phone:404-351-2220
Mailing Address - Fax:
Practice Address - Street 1:3225 CUMBERLAND BLVD SE STE 900
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5971
Practice Address - Country:US
Practice Address - Phone:404-351-2220
Practice Address - Fax:404-352-5392
Is Sole Proprietor?:No
Enumeration Date:2013-03-31
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA077717207W00000X, 207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003200154AMedicaid
GA202I188600OtherMEDICARE PTAN