Provider Demographics
NPI:1487875852
Name:JAYANTHI, SATYA (MD)
Entity type:Individual
Prefix:MRS
First Name:SATYA
Middle Name:
Last Name:JAYANTHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SATYA
Other - Middle Name:
Other - Last Name:CHENNUBHOTLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:3495 PIEDMONT ROAD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1736
Mailing Address - Country:US
Mailing Address - Phone:404-949-5019
Mailing Address - Fax:404-364-4985
Practice Address - Street 1:1000 JOHNSON FERRY ROAD
Practice Address - Street 2:KP NORTHSIDE HOSPITAL SERVICES
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-949-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98694208M00000X
GA060108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist