Individual
SARVOTHAM KINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
108 SPEAR RD, SUITE 309, ATHENS, GA 30602-0001
(706) 542-9592
(706) 713-2222
Mailing address
3959 WHITE HORSE LN SE, SMYRNA, GA 30080-6408
(843) 412-0072
(706) 713-2222
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
034170
GA
207P00000X
Emergency Medicine Physician
13292
SC
207R00000X
Internal Medicine Physician
Primary
034170
GA
208D00000X
General Practice Physician
034170
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003100353A
—
GA
05
—
132920
—
SC
Enumeration date
08/29/2006
Last updated
03/31/2016
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