Kondapaneni, Jyothirmai
Kondapaneni, Jyothirmai is an individual health care provider with primary practice located at 2400 Mount Zion Pkwy Kp Southwood Medical Center, Jonesboro GA 30236-2500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Kondapaneni, Jyothirmai can be contacted via phone (770) 603-3572.Contact Information
Primary practice address
2400 Mount Zion Pkwy Kp Southwood Medical Center
Jonesboro GA 30236-2500
Phone: (770) 603-3572
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 058052 | Georgia |
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 58052 | Georgia |
Profile Details
| NPI number | 1508801978 |
|---|---|
| LBN Legal business name | Kondapaneni, Jyothirmai |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 18th, 2006 |
| Last updated | Jan 13th, 2022 - about 2 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 | 1508801978 | NPPES |
| Georgia | MEDICAID | 876548862A |
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