Polokoff, Jay Howard

Polokoff, Jay Howard is an individual health care provider with primary practice located at 455 Philip Blvd, Suite 130 Kaiser Permanente Lawrenceville Medical Center, Lawrenceville GA 30046. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Polokoff, Jay Howard can be contacted via phone (678) 985-5006.

Contact Information

Primary practice address
455 Philip Blvd, Suite 130 Kaiser Permanente Lawrenceville Medical Center Lawrenceville GA 30046
Phone: (678) 985-5006
Fax: (770) 449-9319
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 026051 Georgia

Profile Details

NPI number 1467415281
LBN Legal business name Polokoff, Jay Howard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2006
Last updated Apr 26th, 2012 - about 14 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 1467415281 NPPES
Georgia MEDICAID 000338511B

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