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General NPI Number Information
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NPI Number | 1558344994
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Entity Type | Individual
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Provider Name | RONALD TIMOTHY JABALEY II MD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 6 ELM ST
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City | BLUE RIDGE
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State | GA
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Zip | 30513-2906
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Country | US
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Telephone | 706-492-4294
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Fax | 706-492-4226
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Provider Business Mailing Address
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Address Line | PO BOX 1058
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City | MC CAYSVILLE
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State | GA
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Zip | 30555-1058
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Country | US
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Telephone | 706-492-4294
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Fax | 706-492-4226
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000035694
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 050718
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 23067
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License Number State | AL
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