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1376603894
W. JEFFERSON PENDERGRAST
ATLANTA, GA
NPI
1376603894
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: GA 015409)
Enumeration Date
2006-12-12
Last Update Date
2011-04-14
Business Address
Dr. W. JEFFERSON PENDERGRAST M.D.
2505 FLAIR KNOLL CT NE
ATLANTA, GA 30345-1311
Phone number: 404-636-2332
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Mailing Address
Dr. W. JEFFERSON PENDERGRAST M.D.
2505 FLAIR KNOLL CT NE
ATLANTA, GA 30345-1311
Phone number: 404-636-2332
Copy
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