MEDICARE: VIJAY JAIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35054838	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093709941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIJAY JAIN MD

Provider Business Mailing Address
First Line	:	600 N PICKAWAY ST
Second Line	:
City	:	CIRCLEVILLE
State	:	OH
Zip	:	43113-2409
Country	:	US
Telephone Number	:	740-420-8078
Fax Number	:	740-477-3594

Provider Business Practice Location Address
First Line	:	6024 HOOVER RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-8133
Country	:	US
Telephone Number	:	614-871-3121
Fax Number	:	614-871-4401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	03/31/2008

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Directions to “ VIJAY JAIN MD” Practice Location

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