Provider Demographics
NPI:1144480963
Name:KRAHNKE, JASON STANLEY (DO)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:STANLEY
Last Name:KRAHNKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 JOHNSON FERRY RD STE C300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1658
Mailing Address - Country:US
Mailing Address - Phone:404-257-0080
Mailing Address - Fax:404-257-0592
Practice Address - Street 1:993 JOHNSON FERRY RD STE C300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1658
Practice Address - Country:US
Practice Address - Phone:404-257-0080
Practice Address - Fax:404-257-0592
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA72324207RC0200X, 207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty