Healthcare Provider Details

I. General information

NPI: 1649977091
Provider Name (Legal Business Name): JMD RHEUM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MEADOW LAKE DR STE 101
HOOVER AL
35242-0302
US

IV. Provider business mailing address

3000 MEADOW LAKE DR STE 101
HOOVER AL
35242-0302
US

V. Phone/Fax

Practice location:
  • Phone: 205-855-5575
  • Fax: 205-272-5040
Mailing address:
  • Phone: 205-855-5575
  • Fax: 205-272-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ARCHANA JAIN
Title or Position: OWNER
Credential: MD
Phone: 205-218-1547