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Individual

DR. CHAYAPATHY JOLLU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10238 SW 86TH CIR UNIT 300, OCALA, FL 34481-7625
(352) 873-1011
(352) 873-1017
Mailing address
10238 SW 86TH CIR UNIT 300, OCALA, FL 34481-7625
(352) 873-1011
(352) 873-1017

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
26157
WI
208100000X
Physical Medicine & Rehabilitation Physician
4301090436
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
ME99148
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110B210270
BCBS
MI
05
1255523551
WI
01
2502210891
BCBS PPO
MI
Enumeration date
08/10/2007
Last updated
05/12/2023
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