Provider Demographics
NPI:1346337227
Name:JANI, BHAVIN H (MD)
Entity Type:Individual
Prefix:
First Name:BHAVIN
Middle Name:H
Last Name:JANI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:868 MICHAEL ETCHISON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-8204
Mailing Address - Country:US
Mailing Address - Phone:770-207-1316
Mailing Address - Fax:770-217-6853
Practice Address - Street 1:705 BREEDLOVE DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655
Practice Address - Country:US
Practice Address - Phone:770-267-6565
Practice Address - Fax:770-267-1524
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2009-10-07
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Provider Licenses
StateLicense IDTaxonomies
GA044498207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00768996AMedicaid
GA00768996AMedicaid