Individual
JAY V SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 MOUNT ZION PKWY, KAISER PERMANENTE SOUTHWOOD COMPREHENSIVE MEDICAL CENTE, JONESBORO, GA 30236-2500
(770) 603-3649
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 504-5678
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
075141
GA
207R00000X
Internal Medicine Physician
271021
NY
Other
Enumeration date
05/20/2010
Last updated
01/10/2022
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