Provider Demographics
NPI:1407053150
Name:SAMANT, JYOTI S (MD)
Entity Type:Individual
Prefix:
First Name:JYOTI
Middle Name:S
Last Name:SAMANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:2055 E SOUTH BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2002
Practice Address - Country:US
Practice Address - Phone:334-284-5211
Practice Address - Fax:334-284-9020
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC141615207R00000X
FLME 97247207R00000X
GA000582207R00000X
AL29766207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine