Provider Demographics
NPI:1720189590
Name:JAIN, ARCHANA (MD)
Entity Type:Individual
Prefix:
First Name:ARCHANA
Middle Name:
Last Name:JAIN
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 1:3000 MEADOW LAKE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-0302
Mailing Address - Country:US
Mailing Address - Phone:205-855-5575
Mailing Address - Fax:205-272-5040
Practice Address - Street 1:3000 MEADOW LAKE DR STE 101
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-0302
Practice Address - Country:US
Practice Address - Phone:205-855-5575
Practice Address - Fax:205-272-5040
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27545207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology