# MR. JESSE A. KANE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1265430292
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 059536 | GA | — |
| 207V00000X | Obstetrics & Gynecology Physician | ME36705 | FL | Yes |

## Other

- **Enumeration date:** 07/13/2005
- **Last updated:** 03/07/2023

## 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 |