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Individual

JAYAKRISHNA AMBATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1300 JEFFERSON PARK AVE, 2ND FLOOR, CHARLOTTESVILLE, VA 22903-3363
(434) 924-5485
(434) 244-9436
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101260900
VA
207W00000X
Ophthalmology Physician
36311
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64032386
KY
Enumeration date
08/30/2006
Last updated
08/08/2023
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