Provider Demographics
NPI:1255542551
Name:KINKARTZ, JASON (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:KINKARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:900 CIRCLE 75 PKWY SE STE 1700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3087
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:770-953-6972
Practice Address - Street 1:1301 SIGMAN RD NE STE 125
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3820
Practice Address - Country:US
Practice Address - Phone:678-413-6276
Practice Address - Fax:678-413-6277
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2023-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA97559207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine