Jago, Kenneth S
Jago, Kenneth S is an sole proprietor health care provider with primary practice located at 125 Oakside Ct Ste 101 , Canton GA 30114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jago, Kenneth S can be contacted via phone (770) 479-3424.Contact Information
Primary practice address
125 Oakside Ct Ste 101
Canton GA 30114
Phone: (770) 479-3424
Fax: (770) 720-3454
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 29476 | Georgia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 029476 | Georgia |
Profile Details
| NPI number | 1538133905 |
|---|---|
| LBN Legal business name | Jago, Kenneth S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Aug 21st, 2019 - about 5 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 | 1538133905 | NPPES |
| Georgia | MEDICAID | 00380575C |
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