Provider Demographics
NPI:1669533113
Name:JIMENEZ, ARNALDO M (MD)
Entity type:Individual
Prefix:
First Name:ARNALDO
Middle Name:M
Last Name:JIMENEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COBBLESTONE WAY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-6805
Mailing Address - Country:US
Mailing Address - Phone:678-546-2929
Mailing Address - Fax:678-546-2921
Practice Address - Street 1:4700 NELSON BROGDON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5400
Practice Address - Country:US
Practice Address - Phone:678-546-2929
Practice Address - Fax:678-546-2921
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA61111207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7449607Medicaid
NJ7449607Medicaid
NJ003196Medicare PIN