Healthcare Provider Details
I. General information
NPI: 1295876076
Provider Name (Legal Business Name): AYMAN AL-JABI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2920 PLAYER ST
BRUNSWICK GA
31520-4923
US
IV. Provider business mailing address
2920 PLAYER ST
BRUNSWICK GA
31520-4923
US
V. Phone/Fax
- Phone: 912-261-2384
- Fax:
- Phone: 912-261-2384
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 36493 |
| License Number State | GA |
VIII. Authorized Official
Name: DR.
AYMAN
AL-JABI
Title or Position: MD
Credential: M.D.
Phone: 912-261-2384