Individual
JITHENDER REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
523 DIXIE ST, SUITE 3, CARROLLTON, GA 30117-3870
(770) 456-3722
(770) 456-3785
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 838-8710
(770) 838-8563
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
064450
GA
2084P0800X
Psychiatry Physician
26715
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267151
—
SC
Enumeration date
06/28/2006
Last updated
05/27/2014
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