Provider Demographics
NPI:1548587256
Name:PINK, JOCHEBED A (MD)
Entity type:Individual
Prefix:
First Name:JOCHEBED
Middle Name:A
Last Name:PINK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1790 MULKEY RD STE 510
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1122
Mailing Address - Country:US
Mailing Address - Phone:470-267-2000
Mailing Address - Fax:470-986-7056
Practice Address - Street 1:1790 MULKEY RD STE 510
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1122
Practice Address - Country:US
Practice Address - Phone:470-267-2000
Practice Address - Fax:470-986-7056
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2024-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA69613207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I114270Medicare PIN