Provider Demographics
NPI:1356303143
Name:JOTANI, RUTWIJ K (MD)
Entity Type:Individual
Prefix:
First Name:RUTWIJ
Middle Name:K
Last Name:JOTANI
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 1:7067 VETERANS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-5118
Mailing Address - Country:US
Mailing Address - Phone:205-884-9000
Mailing Address - Fax:205-884-8111
Practice Address - Street 1:7067 VETERANS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-5118
Practice Address - Country:US
Practice Address - Phone:205-884-9000
Practice Address - Fax:205-884-8111
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00027238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL9938311Medicaid
H93666Medicare UPIN