Organization
SANJEEVA RAO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJEEVA H RAO MD (OWNER)
(770) 775-4334
Entity
Organization
Contact information
Practice address
232 W 2ND ST, JACKSON, GA 30233-1907
(770) 775-4334
(770) 775-7573
Mailing address
232 W 2ND ST, JACKSON, GA 30233-1907
(770) 775-4334
(770) 775-7573
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
018723GA
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00299989A
—
GA
Enumeration date
09/28/2006
Last updated
07/11/2008
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