Provider Demographics
NPI:1023020963
Name:DARJI, JAYKRISHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYKRISHNA
Middle Name:
Last Name:DARJI
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 1:767 PEACHTREE PKWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9348
Mailing Address - Country:US
Mailing Address - Phone:678-208-3460
Mailing Address - Fax:678-374-4902
Practice Address - Street 1:767 PEACHTREE PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9348
Practice Address - Country:US
Practice Address - Phone:678-208-3460
Practice Address - Fax:678-374-4902
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA58862207P00000X, 207QA0401X, 207Q00000X
ALAL15443207P00000X
ALL-2654207P00000X
AL27554207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA659059934GMedicaid
F33010Medicare UPIN