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Deactivated NPI 1114925807 Deactivated / Inactive NPI Male Practitioner

Dr. John A Ezzard , MD

Specialist • Tiger, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Ezzard has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 07, 2005
NPI Deactivation Date January 03, 2018
Total Practice Duration ~13 Years of Practice (2005 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. John Ezzard, MD was a registered Specialist practicing in Tiger, GA. Throughout an active medical career spanning 13 years, Dr. Ezzard provided care at the practice location at 19 ENGLISH ST until profile deactivation on 2018-01-03.

Practice Location & Contact Primary Location

Practice Address

19 English St

Tiger, GA 30576

Telephone 7067823572
Fax 7067821255
Associated Practice Facility / Clinic
🏢 Peachtree Urology, Pc Facility NPI 1013958511

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Tiger, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 36.1 Yrs
Regional Practice Density
1 Specialists

Practicing in Tiger, GA (979 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License GA 009476

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 03, 2018

Record deactivated on January 03, 2018

NPI Profile Active May 28, 2010

NPI status registered as active in NPPES database

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Updated Practice Location May 28, 2010

Registered at 19 ENGLISH ST, TIGER, GA 30576 (Tel: 7067823572)

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Updated Business Mailing Address May 28, 2010

Registered at 3525 PIEDMONT RD NE, BLDG 7-601, ATLANTA, GA 303051578 (Tel: 4048425400)

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Provider Name / Credentials Updated May 28, 2010

Recorded as JOHN EZZARD, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 28, 2010

Specialist (License #009476 in GA)

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Initial NPI Registration & Enumeration July 07, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114925807
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 07, 2005
Last Update: May 28, 2010
Deactivation Date: January 03, 2018

Mailing Address

3525 Piedmont Rd Ne, Bldg 7-601

Atlanta, GA 303051578

Phone: 4048425400

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.