Provider Demographics
NPI:1558344994
Name:JABALEY, RONALD TIMOTHY II (MD)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:TIMOTHY
Last Name:JABALEY
Suffix:II
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:PO BOX 1058
Mailing Address - Street 2:
Mailing Address - City:MC CAYSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30555-1058
Mailing Address - Country:US
Mailing Address - Phone:706-492-4294
Mailing Address - Fax:706-492-4226
Practice Address - Street 1:6 ELM ST
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-2906
Practice Address - Country:US
Practice Address - Phone:706-492-4294
Practice Address - Fax:706-492-4226
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000035694207R00000X
GA050718207R00000X
AL23067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89066FEMedicaid
GA00056372CMedicaid
110243133OtherRAILROAD MEDICARE
TN3876328Medicaid
110243133OtherRAILROAD MEDICARE
GA00056372CMedicaid
GA11BDWGDMedicare PIN