Basic Information
| Provider Information | |||||||||
| NPI: | 1649228651 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENDER | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 HOWELL MILL RD NW STE 800 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303180922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782983239 | ||||||||
| FaxNumber: | 4044771162 | ||||||||
| Practice Location | |||||||||
| Address1: | 1265 HIGHWAY 54 W STE 4200 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788291060 | ||||||||
| FaxNumber: | 6788291099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 050002 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.