Healthcare Provider Details

I. General information

NPI: 1992181671
Provider Name (Legal Business Name): JAYANTA K DIRGHANGI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7655 POPLAR AVE SUITE 360
GERMANTOWN TN
38138-3957
US

IV. Provider business mailing address

7655 POPLAR AVE SUITE 360
GERMANTOWN TN
38138-3957
US

V. Phone/Fax

Practice location:
  • Phone: 901-752-5666
  • Fax: 901-752-3939
Mailing address:
  • Phone: 901-752-5666
  • Fax: 901-752-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAYANTA K DIRGHANGI
Title or Position: SOLE OWNER
Credential: MD
Phone: 901-752-5666