Therattil, Jaya M.
Therattil, Jaya M. is an sole proprietor health care provider with primary practice located at 3630 J Dewey Gray Cir , Augusta GA 30909-1867. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy is her primary health care specialty. Therattil, Jaya M. can be contacted via phone (706) 855-6130.Contact Information
Primary practice address
3630 J Dewey Gray Cir
Augusta GA 30909-1867
Phone: (706) 855-6130
Fax: (706) 855-6139
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology | 2080P0201X | 048731 | Georgia |
| Allopathic & Osteopathic Physicians / Allergy | 207KA0200X | 048731 | Georgia |
Profile Details
| NPI number | 1043285810 |
|---|---|
| LBN Legal business name | Therattil, Jaya M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Jul 14th, 2021 - about 3 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 | 1043285810 | NPPES |
| Georgia | MEDICAID | 000893802B | |
| Georgia | MEDICAID | 000893802D | |
| Georgia | MEDICAID | G48731 | |
| Georgia | MEDICAID | 000893802C |
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