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Contact Information

JERRY R WILBORN JR, MD
1000 JOHNSON FERRY RD NE
ATLANTA, GA30342-1606
 Phone: 404-851-6936
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JERRY R WILBORN JR · (Male)

NPI # 1629042999
Status Active
Credentials MD
Entity Individual
Enumeration date 02/14/2006
Last updated 11/12/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 045666
  • GA Medicaid 000792503
  • GA Medicaid 000792503I
  • GA Medicaid 000792503J
  • GA Other 00000011837 1ST MEDICAL NETWORK
  • GA Other 10038155 AMERIGROUP
  • GA Other 006083 BCBS
  • GA Other 380007 BCBS
  • GA Other 10655 KAISER
Hospital affiliation(s)
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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