Provider Demographics
NPI:1366596405
Name:JANI, HIRENKUMAR (MD)
Entity type:Individual
Prefix:
First Name:HIRENKUMAR
Middle Name:
Last Name:JANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1388
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-2061
Mailing Address - Country:US
Mailing Address - Phone:205-280-1080
Mailing Address - Fax:205-280-1470
Practice Address - Street 1:260 HEALTH CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-2329
Practice Address - Country:US
Practice Address - Phone:205-280-1080
Practice Address - Fax:205-280-1470
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19650207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000096510Medicaid
AL51096510OtherBCBS OF ALABAMA
AL000096510Medicaid
AL000096510Medicare ID - Type Unspecified