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General NPI Number Information
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NPI Number | 1720116494
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Entity Type | Individual
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Provider Name | JYOTSNA TALAPANENI M.D.,
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 301 PHILIP BLVD SUITE A
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8745
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Country | US
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Telephone | 770-822-5560
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Fax | 770-822-4989
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Provider Business Mailing Address
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Address Line | 301 PHILIP BLVD STE A
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8746
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Country | US
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Telephone | 770-822-5560
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Fax | 770-822-4989
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 59212
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License Number State | GA
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