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General NPI Number Information
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NPI Number | 1720289119
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Entity Type | Organization
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Legal Business Name | AJAY KUMAR MD LLC
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 132 SPARTA HWY
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City | EATONTON
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State | GA
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Zip | 31024-8492
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Country | US
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Telephone | 706-485-8495
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Fax | 706-485-7541
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Provider Business Mailing Address
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Address Line | PO BOX 4608
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City | EATONTON
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State | GA
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Zip | 31024-4608
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Country | US
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Telephone | 706-485-8495
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Fax | 706-485-7541
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Authorized Official
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Title or Position | OWNER
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Name | AJAY KUMAR
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Credential | M.D
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Telephone | 706-485-8495
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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 |
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License Number State |
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