Provider Demographics
NPI:1831758846
Name:DIABETES AND ENDOCRINOLOGY ASSOCIATES EAST
Entity type:Organization
Organization Name:DIABETES AND ENDOCRINOLOGY ASSOCIATES EAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-299-2223
Mailing Address - Street 1:2665 N DECATUR RD STE 520
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6146
Mailing Address - Country:US
Mailing Address - Phone:404-299-2223
Mailing Address - Fax:404-297-5003
Practice Address - Street 1:1501 MILSTEAD RD NE STE 100
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3849
Practice Address - Country:US
Practice Address - Phone:770-388-0118
Practice Address - Fax:770-388-9441
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIABETES AND ENDOCRINOLOGY ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-12
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty