Individual
MAANASA JETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
811 S WASHINGTON AVE, MARSHALL, TX 75670-5336
(903) 315-1488
(903) 315-1656
Mailing address
PO BOX 4207, LONGVIEW, TX 75606-4207
(903) 315-1488
(903) 315-1656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P2688
TX
208M00000X
Hospitalist Physician
Primary
P2688
TX
Other
Enumeration date
09/24/2009
Last updated
03/06/2024
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