Organization
JETTY PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAVEEN JETTY M.D. (OWNER/M.D.)
(205) 785-2000
Entity
Organization
Contact information
Practice address
401 TUSCALOOSA AVE SW, SUITE 110, BIRMINGHAM, AL 35211-1416
(205) 785-2000
(205) 785-2945
Mailing address
PO BOX 382664, BIRMINGHAM, AL 35238-2664
(205) 785-2000
(205) 785-2954
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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