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Individual

DR. PRATHAP JAYARAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11 ORTHO LN, ATLANTA, GA 30329
(410) 225-8790
Mailing address
11 ORTHO LN, ATLANTA, GA 30329-2038

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
90850
GA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
45938
TX
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
90850
GA

Other

Enumeration date
05/14/2012
Last updated
07/15/2022
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