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NPI Code Detail

MEDICARE: MRS. JYOTI GHARGE MD

MEDICARE: MRS. JYOTI GHARGE 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
1208100000XPhysical Medicine & Rehabilitation Physician055750GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
152187050002OTHERGABCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720015027
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JYOTI GHARGE MD
Provider Business Mailing Address
First Line : 1909 ABERDEEN RD
Second Line : SUITE 104
City : ALBANY
State : GA
Zip : 31701
Country : US
Telephone Number : 229-430-7256
Fax Number : 229-430-7258
Provider Business Practice Location Address
First Line : 2200 PATRICK HENRY PKWY
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-4207
Country : US
Telephone Number : 817-284-9850
Fax Number : 817-284-9859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 11/15/2024

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