CHARLES V POLLACK JR.


Address: 1120 Wilde Run Ct, Roswell, GA 30075-7163
Phone: 6103292986

CHARLES V POLLACK JR. (NPI# 1467497479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467497479
Entity Type Individual
Full Name CHARLES V POLLACK JR.
Credential MD
Practice Address 1120 Wilde Run Ct
Roswell
GA 30075-7163
Mailing Address Po Box 308
Roswell
GA 30077-0308
Practice Telephone 6103292986
Practice Fax Number 8889598345
Mailing Telephone 6103292986
Mailing Fax Number 8889598345
Enumeration Date 2006-06-17
Last Update Date 2020-11-06
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207P00000X Emergency Medicine MD072992L PA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NJ 8435502 05
PA 0018330190001 05

Office Location

Street Address 1120 WILDE RUN CT
City ROSWELL
State GA
Zip Code 30075-7163

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NPI Name Taxonomy Address Enumeration
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1043712524 Lena Claire Morison Music Therapist 12060 Etris Rd. #200, Roswell, GA 30075 2018-03-01
1790232031 Christina Danielle Dicioccio Physician Assistant 11040 Crabapple Rd # Suiea, Roswell, GA 30075 2016-09-02
1720531767 Arbor Cove Therapy LLC Social Worker 981 Canton St, Suite 200-e, Roswell, GA 30075 2016-07-26
1740640887 Christina C Plaice Counselor 10882 Crabapple Road, Suite 2, Roswell, GA 30075 2016-03-02
1215316435 Jlm X-ray LLC Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 1015 Canton Street, Roswell, GA 30075 2015-05-20
1174953624 Ellen Terrell Occupational Therapist 10050 Crabapple Road, Suite D-115a, Roswell, GA 30075 2013-11-20
1114269974 Patricia E Hernandez Nurse Practitioner 10479 Alpharetta St Ste 18, Roswell, GA 30075 2013-03-20
1750623658 The George Center Foundation Music Therapist 1206 Etris Rd., Suite 200, Roswell, GA 30075 2013-03-19
1407187735 Rachael Anne Templeton Chiropractor 593 Atlanta Street, Gorman Chiropractic, Roswell, GA 30075 2010-01-27
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Taxonomy Information

Taxonomy Code 207P00000X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine

Taxonomy Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source]
- Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1235303090 Jason Taylor Pope Emergency Medicine 1008 Mullis St, Roswell, NM 88201-1157 2008-04-14
1053583948 West Road Emergency Physicians Emergency Medicine 117 East 19th St., Roswell, NM 88201-5151 2008-03-31
1730365669 Mrunalee Milan Mehta Emergency Medicine 720 Glen Royal Dr, Roswell, GA 30076-3649 2008-01-09
1134282114 Damon C. Kimes Emergency Medicine 1300 Upper Hembree Rd Ste B, Roswell, GA 30076-0927 2006-12-19
1598874794 Alto Medical Services, PC Emergency Medicine 2110 S Main Street, Roswell, NM 88203 2006-08-30
1457467649 David M Turner Emergency Medicine 1600 Se Main, Suite F, Roswell, NM 88203 2006-08-21
1487678918 Lisa M Perez Emergency Medicine 303 Bombay Ln, Roswell, GA 30076-5816 2006-07-27
1548298383 Hulannie Jenkins Emergency Medicine 245 Boulder Dr, Roswell, GA 30075-4158 2006-06-29
1245270727 Bernard F Oddi Emergency Medicine 328 Lum Crowe Rd, Roswell, GA 30075-6879 2006-06-06
1235188558 Cydney Roller Emergency Medicine 400 N Pennsylvania Ave Ste 101, Roswell, NM 88201-4754 2006-05-06
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Competitor

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City ROSWELL
Zip Code 30075

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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