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JAYA M. THERATTIL M.D.

Allergy

Augusta, Georgia

Provider NPI: 1043285810

Provider Information:
 JAYA M. THERATTIL M.D.


Practice Location:
3630 J DEWEY GRAY CIR  AUGUSTA, GA 30909 US
Tel: 706-855-6130  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207KA0200XPhysicians
Allergy & Immunology
Allergy
GA048731
Y2080P0201XPhysicians
Pediatrics
GA048731

Other Provider Identifiers:

IssuerNumberStateType
000893802BGA05
000893802DGA05
G48731SC05
000893802CGA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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