Provider Demographics
NPI:1891095329
Name:GINDLER, JACQUELINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:GINDLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 BILTMORE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3835
Mailing Address - Country:US
Mailing Address - Phone:678-488-6426
Mailing Address - Fax:
Practice Address - Street 1:1799 BRIARCLIFF RD NE
Practice Address - Street 2:SUITE X
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-2142
Practice Address - Country:US
Practice Address - Phone:404-745-4578
Practice Address - Fax:404-745-4579
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031923208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics