Provider Demographics
NPI:1992181671
Name:JAYANTA K DIRGHANGI MD PC
Entity Type:Organization
Organization Name:JAYANTA K DIRGHANGI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAYANTA
Authorized Official - Middle Name:K
Authorized Official - Last Name:DIRGHANGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-752-5666
Mailing Address - Street 1:7655 POPLAR AVE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3957
Mailing Address - Country:US
Mailing Address - Phone:901-752-5666
Mailing Address - Fax:901-752-3939
Practice Address - Street 1:7655 POPLAR AVE
Practice Address - Street 2:SUITE 360
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3957
Practice Address - Country:US
Practice Address - Phone:901-752-5666
Practice Address - Fax:901-752-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty