Provider Demographics
NPI:1831262385
Name:KADAKIA, JATIN K (MD)
Entity type:Individual
Prefix:
First Name:JATIN
Middle Name:K
Last Name:KADAKIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:311 LANDRUM PL
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043
Mailing Address - Country:US
Mailing Address - Phone:931-648-8314
Mailing Address - Fax:931-647-3841
Practice Address - Street 1:311 LANDRUM PL
Practice Address - Street 2:SUITE 700
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043
Practice Address - Country:US
Practice Address - Phone:931-648-8314
Practice Address - Fax:931-647-3841
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN25152207LC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F51019Medicare UPIN