Healthcare Provider Details
I. General information
NPI: 1477525624
Provider Name (Legal Business Name): CHIRAG R JANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/02/2006
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
427 W 3RD AVE
ALBANY GA
31701-1975
US
IV. Provider business mailing address
427 W 3RD AVE
ALBANY GA
31701-1975
US
V. Phone/Fax
- Phone: 229-312-5800
- Fax: 229-312-5853
- Phone: 229-312-5800
- Fax: 229-312-5853
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 052354 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: