Provider Demographics
NPI:1801930052
Name:HIRENKUMAR JANI MD PC
Entity type:Organization
Organization Name:HIRENKUMAR JANI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIRENKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-280-1080
Mailing Address - Street 1:PO BOX 1388
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-2061
Mailing Address - Country:US
Mailing Address - Phone:205-280-1080
Mailing Address - Fax:205-280-1470
Practice Address - Street 1:260 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-2367
Practice Address - Country:US
Practice Address - Phone:205-280-1080
Practice Address - Fax:205-280-1470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19650207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000096510Medicaid
AL51096510OtherBLUE CROSS BLUE SHIELD AL
AL000096510Medicaid
AL000096510Medicare ID - Type Unspecified