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Individual

EILEEN JAVELLANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(678) 207-4373
(770) 533-4727
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 533-4786

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
045841
GA
207RB0002X
Obesity Medicine (Internal Medicine) Physician
045841
GA
208M00000X
Hospitalist Physician
045841
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000800555B
GA
05
000800555C
GA
05
000800555D
GA
05
000800555E
GA
05
000800555F
GA
05
000800555G
GA
05
000800555H
GA
05
000800555I
GA
05
000800555J
GA
05
000800555K
GA
05
000800555L
GA
05
000800555M
GA
05
000800555N
GA
01
0400503
UNITED HEALTHCARE
GA
01
10045921
AMERIGROUP
GA
01
110029C048846
TRAILBLAZER HEALTH ENTERPRISES
GA
01
110211686
RR MEDICARE-GRP # CC4177
GA
01
11BDRZS
MEDICARE CAHABA GBA
GA
01
2448449
CIGNA
GA
01
340854
WELLCARE
GA
01
52598478
BCBS
GA
01
582117020
TRICARE CERTIFIED
GA
01
582117020045
TRICARE CERTIFIED
GA
01
582117020055
TRICARE CERTIFIED
GA
01
582117020057
TRICARE CERTIFIED
GA
01
767999
COVENTRY HEALTHCARE
GA
01
783517
ATENA
GA
Enumeration date
01/18/2006
Last updated
05/07/2024
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