Individual
DR. JITENDRA A JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 ESSEX CT, STE A, MADISON, AL 35758
(256) 461-8442
(256) 461-8447
Mailing address
102 ESSEX CT, STE A, MADISON, AL 35758-3160
(256) 461-8442
(256) 461-8447
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21602
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009962215
—
AL
01
—
51522575
BCBS OF ALABAMA
AL
Enumeration date
11/21/2005
Last updated
02/07/2011
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