Provider Demographics
NPI:1831201862
Name:ACHARYA, AJAY A (MD)
Entity type:Individual
Prefix:DR
First Name:AJAY
Middle Name:A
Last Name:ACHARYA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9454 THREE RIVERS RD
Mailing Address - Street 2:STE D
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4294
Mailing Address - Country:US
Mailing Address - Phone:228-575-2660
Mailing Address - Fax:228-863-0502
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:352-376-1611
Practice Address - Fax:352-379-4174
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2020-12-21
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Provider Licenses
StateLicense IDTaxonomies
MS13819207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine