Provider Demographics
NPI:1528159241
Name:CHAWLA, JYOTI R (MD)
Entity type:Individual
Prefix:DR
First Name:JYOTI
Middle Name:R
Last Name:CHAWLA
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 1:8331 AMBERLEIGH WAY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8896
Mailing Address - Country:US
Mailing Address - Phone:234-222-4142
Mailing Address - Fax:
Practice Address - Street 1:9572 DUBLIN RD
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8973
Practice Address - Country:US
Practice Address - Phone:342-224-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-083558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2499443Medicaid
OH2499443Medicaid