Individual
DR. ROBERT JAY BALOTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ACADEMY STREET, GAINESVILLE, GA 30501
(770) 282-8820
Mailing address
PO BOX 2417, GAINESVILLE, GA 30503-2417
(770) 532-9936
(770) 534-9877
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
043163
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000737107E
—
GA
05
—
000737107N
—
GA
01
—
581177261A
MEDICARE GRP PROV #
GA
01
—
P00298084
RAILROAD MEDICARE
GA
Enumeration date
10/11/2006
Last updated
01/12/2021
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