Provider Demographics
NPI:1295876076
Name:AYMAN AL-JABI MD PC
Entity type:Organization
Organization Name:AYMAN AL-JABI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-JABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-261-2384
Mailing Address - Street 1:2920 PLAYER ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4923
Mailing Address - Country:US
Mailing Address - Phone:912-261-2384
Mailing Address - Fax:
Practice Address - Street 1:2920 PLAYER ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4923
Practice Address - Country:US
Practice Address - Phone:912-261-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA36493208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00532155AMedicaid