Provider Demographics
NPI:1467651455
Name:JITENDRA G. GANDHI
Entity Type:Organization
Organization Name:JITENDRA G. GANDHI
Other - Org Name:ASSOCIATES IN ONCOLOGY AND HEMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JITENDRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-622-2337
Mailing Address - Street 1:7425 ZIEGLER RD STE 109
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4178
Mailing Address - Country:US
Mailing Address - Phone:423-622-2337
Mailing Address - Fax:
Practice Address - Street 1:7425 ZIEGLER RD STE 109
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4178
Practice Address - Country:US
Practice Address - Phone:423-622-2337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD14781174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000285Medicaid
TNQ45781Medicare UPIN
TNA96602Medicare UPIN