Provider Demographics
NPI:1497745632
Name:JHA, ASIT K (MD)
Entity Type:Individual
Prefix:
First Name:ASIT
Middle Name:K
Last Name:JHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 749495
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9495
Mailing Address - Country:US
Mailing Address - Phone:239-432-8331
Mailing Address - Fax:813-321-1296
Practice Address - Street 1:1206 ALICE ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-4525
Practice Address - Country:US
Practice Address - Phone:912-285-1140
Practice Address - Fax:912-285-1125
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA055248207RX0202X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA9355145OtherAETNA
GA1251795OtherAMERIGROUP
GA202G708768OtherMEDICARE GROUP PTAN
GADQ2362OtherRAILROAD GROUP
GA52187455OtherBCBS
GA286691036GMedicaid
GA286691036IMedicaid
GA490051OtherWELLCARE
GA1251795OtherAMERIGROUP
GA52187455OtherBCBS