Jonathan Woolfson, MD, PC

Organization Active NPI Ophthalmology Physician · Jasper, GA

NPI 1508196601 · NPPES record last updated Dec 4, 2024

Key facts

NPI
1508196601
Entity type
Organization (NPI type 2)
Primary specialty
Ophthalmology Physician 207W00000X
Legal business name
JONATHAN WOOLFSON, MD, PC
Practice address
150 Interstate South Dr
Suite 200
Jasper, GA 30143-6211
Phone
(706) 253-2267
Fax
(678) 454-7331
NPI assigned
Jan 12, 2010
Organization subpart
No

Authorized official

Name
Dr. Jonathan M Woolfson, M.D.
Title
Ceo
Phone
(770) 804-1684

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040505000641 GA Part B Supplier - Clinic/Group Practice 8426046665 Receives reassigned benefits from 34 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Douglasville, GA; Tyrone, GA; Stockbridge, GA; Snellville, GA; Roswell, GA; Peachtree City, GA; Marietta, GA; Lawrenceville, GA…

National Provider Directory

Tax ID family
Jonathan Woolfson MD PC (15 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207W00000X Yes

Addresses

Primary practice location

150 Interstate South Dr
Suite 200
Jasper, GA 30143-6211

Mailing address

PO Box 63174
Charlotte, NC 28263-3174
Phone (770) 804-1684

Other providers in Jasper, GA

All providers in Jasper, GA · Ophthalmology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.