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Individual

JAGADISHWAR DEVKOTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20 WINGED FOOT DR, AUGUSTA, GA 30907-9140
(706) 414-8235
(706) 364-2606
Mailing address
20 WINGED FOOT DR, AUGUSTA, GA 30907-9140
(706) 414-8235
(706) 364-2606

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
017602
GA
208D00000X
General Practice Physician
Primary
017602
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00185138D
GA
Enumeration date
10/19/2006
Last updated
04/25/2017
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