Provider Demographics
NPI:1003347881
Name:HARI, KRUPAL JAY (MD)
Entity Type:Individual
Prefix:
First Name:KRUPAL
Middle Name:JAY
Last Name:HARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 KING AVENUE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606
Mailing Address - Country:US
Mailing Address - Phone:706-475-1700
Mailing Address - Fax:706-475-1790
Practice Address - Street 1:242 KING AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-475-1700
Practice Address - Fax:706-475-1790
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA95712207R00000X, 207RC0000X
NC2021-02836207R00000X, 207RC0000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist