Organization
M & M INTERVENTIONAL SPINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLU JABATI (MEDICAL DIRECTOR)
(678) 559-4526
Entity
Organization
Contact information
Practice address
91 SAMMY MCGHEE BLVD STE 101, JASPER, GA 30143-7704
(706) 253-3367
(706) 253-3361
Mailing address
91 SAMMY MCGHEE BLVD STE 101, JASPER, GA 30143-7704
(706) 253-3367
(706) 253-3361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
058527
GA
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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