Provider Demographics
NPI:1538165352
Name:JOFFE, ALAN L (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:JOFFE
Suffix:
Gender:M
Credentials:MD
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 NE
Mailing Address - Street 2:BLD C STE 120
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1620
Mailing Address - Country:US
Mailing Address - Phone:404-256-2811
Mailing Address - Fax:404-257-9855
Practice Address - Street 1:993 JOHNSON FERRY RD NE
Practice Address - Street 2:BLD C STE 120
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-256-2811
Practice Address - Fax:404-257-9855
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021164174400000X, 207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582348494OtherTAX ID OTHER PROVIDERS
GA000478827AMedicaid
GA000478827AMedicaid
GA582348494OtherTAX ID OTHER PROVIDERS