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Individual

DR. JARED GICHANA NYABUTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
305 W JACKSON ST STE 200, CARBONDALE, IL 62901-1474
(618) 536-6621
(618) 453-1102
Mailing address
305 W JACKSON ST STE 200, CARBONDALE, IL 62901-1474

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125061993
IL
208M00000X
Hospitalist Physician
Primary
42846
IA

Other

Enumeration date
06/29/2012
Last updated
10/28/2022
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