Provider Demographics
NPI:1447205950
Name:JAGANI, ASHOK (MD)
Entity Type:Individual
Prefix:MR
First Name:ASHOK
Middle Name:
Last Name:JAGANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MS
Other - First Name:PUSHPA
Other - Middle Name:
Other - Last Name:JAGANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2702 HOSPITAL DR
Mailing Address - Street 2:S-201
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-3397
Mailing Address - Country:US
Mailing Address - Phone:205-339-3911
Mailing Address - Fax:334-230-5549
Practice Address - Street 1:2702 HOSPITAL DR
Practice Address - Street 2:S-201
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3397
Practice Address - Country:US
Practice Address - Phone:205-339-3911
Practice Address - Fax:334-230-5549
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22377207KA0200X, 207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000096682Medicaid
AL631252695OtherCIGNA/FIRST HEALTHCARE
AL000096682VAGMedicare ID - Type Unspecified
AL000096682Medicaid