Healthcare Provider Details
I. General information
NPI: 1437840568
Provider Name (Legal Business Name): JIMMY SOJAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/18/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
392 S DONAHUE DR
AUBURN AL
36849-5321
US
IV. Provider business mailing address
392 S DONAHUE DR
AUBURN AL
36849-5321
US
V. Phone/Fax
- Phone: 855-282-2010
- Fax:
- Phone: 855-282-2010
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 4679 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: