Provider Demographics
NPI:1255403481
Name:JABLONSKI, ERIC A (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:JABLONSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:211 BOBBY JONES EXPY
Mailing Address - Street 2:STE C
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5250
Mailing Address - Country:US
Mailing Address - Phone:706-860-3355
Mailing Address - Fax:706-860-8765
Practice Address - Street 1:211 BOBBY JONES EXPY
Practice Address - Street 2:STE C
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5250
Practice Address - Country:US
Practice Address - Phone:706-860-3355
Practice Address - Fax:706-860-8765
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20270G5260OtherMEDICARE GROUP ACTION MEDICAL CENTER LLC
GAGRP3167OtherMEDICARE GROUP NUMBER
GA35ZCFFRMedicare PIN
GAT62288Medicare UPIN