Dr. Jay R Prakash
Gastroenterologist
6555 Professional Pl Suite C
Riverdale
, Georgia 30274-2519
Dr. Jay R Prakash
Gastroenterologist
6555 Professional Pl Suite C
Riverdale
, Georgia 30274-2519
(770) 991-1596
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About
Features
Specialties
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Jay R Prakash
- 6555 Professional Pl Suite C
- Riverdale, GA
- Zip : 30274-2519
- Fax : (770) 991-1596
- Phone : (770) 996-5959
Second Address
- Dr. Jay R Prakash
- 6555 Professional Pl Suite C
- Riverdale, GA
- Zip : 30274-2519
- Fax : (770) 991-1596
- Phone : (770) 996-5959
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0100X | Gastroenterologist | 025986 | GA |
National Provider Identifier
| NPI | 1003846635 |
|---|---|
| Provider Name | Dr. Jay R Prakash |
| First Address | Riverdale, GA 30274-2519 |
| Second Address | Riverdale, GA 30274-2519 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/07/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00292322A | (05) | GA |
| D40253 | (02) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.