Samuel, Jason T

Samuel, Jason T is an sole proprietor health care provider with primary practice located at 110 3Rd St Suite 310, Henderson KY 42420-2993. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Samuel, Jason T can be contacted via phone (270) 826-1266.

Contact Information

Primary practice address
110 3Rd St Suite 310 Henderson KY 42420-2993
Phone: (270) 826-1266
Fax: (270) 827-5385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 18556 Kentucky
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 01034049A Indiana

Profile Details

NPI number 1285820852
LBN Legal business name Samuel, Jason T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 18th, 2007
Last updated May 18th, 2015 - about 10 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 1285820852 NPPES
Indiana MEDICAID 100247420A
Indiana MEDICAID 64185564

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