Individual provider · Type 1 NPI
Jyotibala Jain, MD
Student in an Organized Health Care Education/Training Program · Caribou, ME
NPI number
1609252808
Active
Practice location
163 Van Buren Rd
Caribou, ME 04736-3567
Mailing address
1935 Medical District Dr
Dallas, TX 75235-7701
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | 590833 (TX) |
| Pediatrics Physician | 208000000X | MD25067 (ME) |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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About NPI 1609252808
Jyotibala Jain, MD's National Provider Identifier is 1609252808, issued on Aug 11, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Caribou, ME. The record was last updated on Jun 9, 2022.