Elikkottil, Jaseena
Elikkottil, Jaseena is an individual health care provider with primary practice located at 4805 Southside Dr , Louisville KY 40214-2111. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Technologists, Technicians & Other Technical Service Providers / Histology, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Elikkottil, Jaseena can be contacted via phone (502) 772-8860.Contact Information
Primary practice address
4805 Southside Dr
Louisville KY 40214-2111
Phone: (502) 772-8860
Fax: (502) 996-8309
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 49109 | Kentucky |
Technologists, Technicians & Other Technical Service Providers / Histology | 246RH0600X | ||
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 22544 | Minnesota |
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 49109 | Kentucky |
Profile Details
NPI number | 1407096233 |
---|---|
LBN Legal business name | Elikkottil, Jaseena |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 6th, 2009 |
Last updated | Aug 3rd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1407096233 | NPPES |
Kentucky | MEDICAID | 7100437200 | |
Kentucky | MEDICAID | 201407600 |
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