Basic Information
| Provider Information | |||||||||
| NPI: | 1891227484 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PIERRE | ||||||||
| FirstName: | JONATHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 136 CARSBROOKE ROAD | ||||||||
| Address2: | |||||||||
| City: | TORONTO | ||||||||
| State: | ONTARIO | ||||||||
| PostalCode: | M9C3C8 | ||||||||
| CountryCode: | CA | ||||||||
| TelephoneNumber: | 4348254649 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 MEDICAL CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300467694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6783121000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2017 | ||||||||
| LastUpdateDate: | 07/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 85063 | GA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.