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General NPI Number Information
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NPI Number | 1649744897
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Entity Type | Organization
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Legal Business Name | J RAPHA HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 01/21/2019
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 100 TIMBER TRAIL RD STE 104
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City | RICHMOND HILL
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State | GA
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Zip | 31324-9416
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Country | US
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Telephone | 912-445-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 100 TIMBER TRAIL RD STE 104
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City | RICHMOND HILL
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State | GA
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Zip | 31324-9416
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Country | US
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Telephone | 912-445-5520
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Fax |
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | EKEI JOSO TANIFUM
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Credential | MD
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Telephone | 912-445-5520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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