Provider Demographics
NPI:1134757347
Name:KALISH, JOSHUA ANDREW
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ANDREW
Last Name:KALISH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 PEACHTREE DUNWOODY RD STE A500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-7162
Mailing Address - Country:US
Mailing Address - Phone:678-892-2020
Mailing Address - Fax:678-538-1972
Practice Address - Street 1:1465 SATELLITE BLVD NW
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4895
Practice Address - Country:US
Practice Address - Phone:678-287-7657
Practice Address - Fax:678-535-0981
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA100491207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology