Provider Demographics
NPI:1154526457
Name:CZARKOWSKI, ALAN GEORGE (DO)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:GEORGE
Last Name:CZARKOWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1397
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30031-1397
Mailing Address - Country:US
Mailing Address - Phone:404-498-4775
Mailing Address - Fax:404-498-4776
Practice Address - Street 1:57 EXECUTIVE PARK SOUTH NE
Practice Address - Street 2:BLDG 57, SUITE 2301
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2288
Practice Address - Country:US
Practice Address - Phone:404-498-4775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0293172083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine