Provider Demographics
NPI:1982712915
Name:SHIH, JOHN YOZEN (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:YOZEN
Last Name:SHIH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:960 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1995
Mailing Address - Country:US
Mailing Address - Phone:770-831-8191
Mailing Address - Fax:770-831-0295
Practice Address - Street 1:960 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1995
Practice Address - Country:US
Practice Address - Phone:770-831-8191
Practice Address - Fax:770-831-0295
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG03045Medicare UPIN
GA08BBTTXMedicare PIN