Provider Demographics
NPI:1932133709
Name:JYOTI GHARGE MD PC
Entity Type:Organization
Organization Name:JYOTI GHARGE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JYOTI
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-430-7256
Mailing Address - Street 1:1909 ABERDEEN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701
Mailing Address - Country:US
Mailing Address - Phone:229-430-7256
Mailing Address - Fax:229-430-7258
Practice Address - Street 1:1909 ABERDEEN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701
Practice Address - Country:US
Practice Address - Phone:229-430-7256
Practice Address - Fax:229-430-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7149Medicare PIN
GADE6343Medicare PIN