Individual
JITHENDER R KANDIMALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 S 8TH ST STE 301, GRIFFIN, GA 30224-4260
(770) 229-6072
(770) 229-2111
Mailing address
655 WILL ST, GRIFFIN, GA 30224-4236
(770) 229-6072
(770) 229-2111
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
072654
GA
208600000X
Surgery Physician
52678
MN
208600000X
Surgery Physician
9950
ND
Other
Enumeration date
05/17/2006
Last updated
10/17/2019
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