Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 125058671 | IL |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 076128 | GA |
NPI | 1255652632 |
---|---|
Provider Name | Jimmy J Jiang |
First Address | Holly Springs, GA 30115-8721 |
Second Address | Holly Springs, GA 30115-8721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2010 |
Last Update Date | 26/02/2021 |