Provider Demographics
NPI:1699715573
Name:ZORA, JOHN A (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:ZORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:114 TOWNPARK DR NW
Mailing Address - Street 2:SUITE 240
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-3715
Mailing Address - Country:US
Mailing Address - Phone:770-952-8612
Mailing Address - Fax:678-803-6944
Practice Address - Street 1:1990 RIVERSIDE PARKWAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043
Practice Address - Country:US
Practice Address - Phone:770-995-1537
Practice Address - Fax:770-822-2940
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA026420207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA03BDBQMOtherMEDICARE ID
GA00292003EMedicaid
D31879Medicare UPIN