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NPI Code Detail

MEDICARE: DR. JOLAIYA Y FATUROTI MD, FACOG

MEDICARE:  DR. JOLAIYA Y FATUROTI  MD, FACOG
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
1207V00000XObstetrics & Gynecology PhysicianA166250CA
2207V00000XObstetrics & Gynecology PhysicianS1201TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F400593349OTHERILMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588074611
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOLAIYA Y FATUROTI MD, FACOG
Provider Business Mailing Address
First Line : 2116 AUSTIN LN
Second Line :
City : PROSPER
State : TX
Zip : 75078-1657
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N COIT RD STE 1504
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-6660
Country : US
Telephone Number : 469-215-1647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2014
Last Update Date : 08/09/2024

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Directions to “ DR. JOLAIYA Y FATUROTI MD, FACOG” Practice Location

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