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:
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Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043285810 NPPES
Georgia MEDICAID 000893802B
Georgia MEDICAID 000893802D
Georgia MEDICAID G48731
Georgia MEDICAID 000893802C

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