Provider Demographics
NPI:1811965445
Name:DOLAK, JAMES ALEXANDER (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALEXANDER
Last Name:DOLAK
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:DEPT. OF ANESTHESIOLOGY, EMORY CRAWFORD LONG HOSP
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-686-2316
Mailing Address - Fax:404-686-4949
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:DEPT. OF ANESTHESIOLOGY, EMORY CRAWFORD LONG HOSP
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-686-2316
Practice Address - Fax:404-686-4949
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036072207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2232435Medicaid
GA036072OtherMEDICAL LICENSE
OH2232435Medicaid
OHDO4042411Medicare ID - Type Unspecified