Individual provider · Type 1 NPI
Jackson L. Gates, MD
General Practice Physician · Conyers, GA
NPI number
1962418400
Active
Practice location
1880 Lancaster Drive
Conyers, GA 30013-6433
Mailing address
777 Cleveland Ave SW, Suite 100
Atlanta, GA 30315-7129
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 038767 (GA) |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 038767 (GA) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Other general practice physician providers in Conyers
About NPI 1962418400
Jackson L. Gates, MD's National Provider Identifier is 1962418400, issued on Aug 1, 2006. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Conyers, GA. The record was last updated on Aug 10, 2010.