Provider Demographics
NPI:1255530762
Name:SERVAT, JUAN JAVIER (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:JAVIER
Last Name:SERVAT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3890 JOHNS CREEK PKWY STE 245
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6697
Mailing Address - Country:US
Mailing Address - Phone:770-604-4141
Mailing Address - Fax:770-604-4140
Practice Address - Street 1:3890 JOHNS CREEK PKWY STE 240
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1286
Practice Address - Country:US
Practice Address - Phone:770-604-4141
Practice Address - Fax:770-604-4140
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095612207W00000X
CT390200000X
GA70909207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003141770AMedicaid