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Individual
MR. JESSE A. KANE
Active
Individual
MR. JESSE A. KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
059536
GA
207V00000X
Obstetrics & Gynecology Physician
Primary
ME36705
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059536
PHYSICIAN LICENSE
GA
05
—
104837400
—
FL
01
—
11D0941435
CLIA ID -2010 OCILLA RD
GA
01
—
11D1105865
CLIA ID - 17 JOHNSON ST
GA
05
—
234608607A
—
GA
05
—
234608607B
—
GA
01
—
421005
WELLCARE OF GA
—
01
—
DH1281
RAILROAD MEDICARE - GROUP #
GA
01
—
P00787893
RAILROAD MEDICARE - PTAN
GA
Enumeration date
07/13/2005
Last updated
03/07/2023
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