Provider Demographics
NPI:1720418841
Name:GOBER, JAIME (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:GOBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3747 ROSWELL RD STE 216
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6227
Mailing Address - Country:US
Mailing Address - Phone:770-973-2272
Mailing Address - Fax:770-973-9245
Practice Address - Street 1:3747 ROSWELL RD STE 216
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062
Practice Address - Country:US
Practice Address - Phone:770-973-2272
Practice Address - Fax:770-973-9245
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN16318207Q00000X
GA079288207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine