Provider Demographics
NPI:1689559171
Name:MATHEWS, JAMAR (HIS)
Entity type:Individual
Prefix:
First Name:JAMAR
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4585 S COBB DR SE STE 400
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6975
Mailing Address - Country:US
Mailing Address - Phone:770-803-9909
Mailing Address - Fax:770-803-9911
Practice Address - Street 1:4585 S COBB DR SE STE 400
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6975
Practice Address - Country:US
Practice Address - Phone:770-803-9909
Practice Address - Fax:770-803-9911
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS001151237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist