Provider Demographics
NPI:1730158254
Name:CLABBY, JAMES W (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:CLABBY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3825 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-6831
Mailing Address - Country:US
Mailing Address - Phone:770-941-8100
Mailing Address - Fax:770-948-0771
Practice Address - Street 1:3825 MEDICAL PARK DR
Practice Address - Street 2:SUITE 201
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-6831
Practice Address - Country:US
Practice Address - Phone:770-941-8100
Practice Address - Fax:770-948-0771
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-02-25
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Provider Licenses
StateLicense IDTaxonomies
GA16042207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D39598Medicare UPIN