MEDICARE: DR. SRI RASMITA JALLA

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	12986	GA
2	207RN0300X	Nephrology Physician	110804	GA

General Provider Information

NPI Number	:	1295302859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SRI RASMITA JALLA

Provider Business Mailing Address
First Line	:	7995 CAVENDISH PL
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-1571
Country	:	US
Telephone Number	:	678-672-7988
Fax Number	:

Provider Business Practice Location Address
First Line	:	4444 AUSTELL RD
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30106-1844
Country	:	US
Telephone Number	:	678-460-2700
Fax Number	:

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

Provider Enumeration Date	:	06/10/2021
Last Update Date	:	06/18/2026

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Directions to “ DR. SRI RASMITA JALLA ” Practice Location

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