Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Azad Mansouri, MD

Individual provider Ophthalmology Physician · NPI 1477744068

Dr. Azad Mansouri, MD is an Ophthalmology in Jonesboro, Georgia. Graduated from Washington University School of Medicine in 2006, 20 years ago. Practices with The Southeast Permanente Medical Group, a 826-clinician group and accepts Medicare assignment. Licensed in Georgia, Maryland, Missouri and Virginia.

Years since qualifying
20
Trained at
Washington University School of Medicine
Licensed in
GA, MD, MO, VA
In the registry since
2007
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2400 Mount Zion Pkwy Kaiser Permanente Southwood Medical Ctr
Jonesboro, GA 30236-2500
Phone: (410) 337-4500
Fax: (410) 339-7326
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence 076153 (GA)
Ophthalmology Physician Taxonomy 207W00000X · Licence 0101247198 (VA)
Ophthalmology Physician Taxonomy 207W00000X · Licence D70402 (MD)
Ophthalmology Physician Taxonomy 207W00000X · Licence 2006017512 (MO)

Record details

NPI number1477744068
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 7, 2007
Last updated in NPPESJanuary 10, 2022
Mailing address3495 Piedmont Rd Ne, Nine Piedmont Center, Atlanta, GA 30305-1717

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPHTHALMOLOGY
Medical schoolWASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2006 (20 years in practice)
Group practice The Southeast Permanente Medical Group — 826 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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