MEDICARE: YOLLA JULES M.D.

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	283Q00000X	Psychiatric Hospital	15738	PR
2	2084P0804X	Child & Adolescent Psychiatry Physician	66174	GA
3	2084P0800X	Psychiatry Physician	66174	GA

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	:	1447213277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLLA JULES M.D.

Provider Business Mailing Address
First Line	:	3120 N OAK STREET EXT
Second Line	:	BEHAVIORAL HEALTH SERVICES OF SOUTH GA
City	:	VALDOSTA
State	:	GA
Zip	:	31602-5909
Country	:	US
Telephone Number	:	229-671-6170
Fax Number	:	229-671-6779

Provider Business Practice Location Address
First Line	:	3120 N OAK STREET EXT
Second Line	:	BEHAVIORAL HEALTH SERVICES OF SOUTH GA
City	:	VALDOSTA
State	:	GA
Zip	:	31602-5909
Country	:	US
Telephone Number	:	229-671-6170
Fax Number	:	229-671-6779

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	10/14/2014

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Directions to “ YOLLA JULES M.D.” Practice Location

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