Individual
DR. DEEPTI JAIN BHASIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
402 OSIGIAN BLVD, SUTIE 400, WARNER ROBINS, GA 31088-8988
(478) 333-3058
(478) 333-3496
Mailing address
402 OSIGIAN BLVD, SUTIE 400, WARNER ROBINS, GA 31088-8988
(478) 333-3058
(478) 333-3496
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
059979
GA
2084F0202X
Forensic Psychiatry Physician
28166
SC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
059979
GA
2084P0804X
Child & Adolescent Psychiatry Physician
MD28166
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104147081
GROUP NPI
GA
01
—
1285717942
INDIVIDUAL NPI
GA
05
—
408444500B
—
GA
Enumeration date
10/23/2006
Last updated
06/11/2012
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