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General NPI Number Information
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NPI Number | 1295739076
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Entity Type | Individual
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Provider Name | JAYAKRISHNAKAMAL KONIJETI MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 4101 TECHNOLOGY AVE
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City | NEW ALBANY
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State | IN
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Zip | 47150-8548
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Country | US
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Telephone | 812-941-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 TECHNOLOGY AVE
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City | NEW ALBANY
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State | IN
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Zip | 47150-8548
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Country | US
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Telephone | 812-941-4500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 01053730A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 38355
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License Number State | KY
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