Individual
JANE ILUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
658 N CHASE ST # 102, ATHENS, GA 30601-1960
(772) 313-3768
(850) 522-8354
Mailing address
2505 HARRISON AVE, PANAMA CITY, FL 32405-4464
(772) 313-3768
(850) 522-5384
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
01073699A
IN
207ND0101X
MOHS-Micrographic Surgery Physician
33945
SC
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
93791
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
93791
GA MEDICAL LICENSE
GA
Enumeration date
03/29/2010
Last updated
11/28/2022
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