Provider Demographics
NPI:1992148431
Name:JAIN, SWEETI BHAKTA (M D)
Entity type:Individual
Prefix:
First Name:SWEETI
Middle Name:BHAKTA
Last Name:JAIN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:SWEETI
Other - Middle Name:RAJENDRA
Other - Last Name:BHAKTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:910 MADISON AVE STE 1031
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 MADISON AVE STE 1031
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3403
Practice Address - Country:US
Practice Address - Phone:901-287-6756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000053570208000000X
TN53570207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics