Illston, Jana Dopson

Illston, Jana Dopson is an sole proprietor health care provider with primary practice located at 11975 Morris Rd Ste 310 , Alpharetta GA 30005-4444. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is her primary health care specialty. Illston, Jana Dopson can be contacted via phone (770) 752-0824.

Contact Information

Primary practice address
11975 Morris Rd Ste 310 Alpharetta GA 30005-4444
Phone: (770) 752-0824
Fax: (770) 752-0845
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 078039 Georgia
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X 78039 Georgia

Profile Details

NPI number 1780904896
LBN Legal business name Illston, Jana Dopson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2010
Last updated Jun 9th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780904896 NPPES
Georgia Other GRP3569 MEDICARE
Georgia MEDICAID 300034164A MEDICARE

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