Jefferson, Ted H

Jefferson, Ted H is an sole proprietor health care provider with primary practice located at 2605 Kentucky Ave Dob#3 Suite 602, Paducah KY 42003-3800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Jefferson, Ted H can be contacted via phone (270) 442-2449.

Contact Information

Primary practice address
2605 Kentucky Ave Dob#3 Suite 602 Paducah KY 42003-3800
Phone: (270) 442-2449
Fax: (270) 442-6628
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 02703 Kentucky

Profile Details

NPI number 1235152943
LBN Legal business name Jefferson, Ted H
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 25th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235152943 NPPES
Kentucky Other 000000200948 ANTHEM
Kentucky MEDICAID 64032436 ANTHEM

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