Jacob Landram
Jacob Landram is a Physician Assistant in Atlanta, Georgia. Qualified in 2023, 3 years ago. Practices with Wellstreet of Georgia PC, a 431-clinician group and accepts Medicare assignment.
- Years since qualifying
- 3
- In the registry since
- 2022
Practice location Address checks out
1800 Howell Mill Rd NW Ste 175Atlanta, GA 30318-0924
Phone: (404) 607-1777
Fax: (404) 607-1799
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1114649936 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 19, 2022 |
| Last updated in NPPES | July 16, 2026 |
| Certification date | July 16, 2026 |
| Mailing address | 1800 Howell Mill Rd Nw Ste 175, Atlanta, GA 30318-0924 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2023 (3 years in practice) |
| Group practice | Wellstreet Of Georgia Pc — 431 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 10 on file with Medicare |
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