Jetly, Rajiv
Jetly, Rajiv is an individual health care provider with primary practice located at 3235 N Windsong Dr , Prescott Valley AZ 86314-1222. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Jetly, Rajiv can be contacted via phone (928) 772-3340.Contact Information
Primary practice address
3235 N Windsong Dr
Prescott Valley AZ 86314-1222
Phone: (928) 772-3340
Fax: (928) 759-9611
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 29064 | Arizona |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 29064 | Arizona |
Profile Details
| NPI number | 1861494247 |
|---|---|
| LBN Legal business name | Jetly, Rajiv |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2005 |
| Last updated | May 11th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861494247 | NPPES |
| Arizona | MEDICAID | 555724 | |
| Arizona | Other | AZ0887390 |
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