Individual
JUSTIN JATCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 E CHESTNUT ST, LOUISVILLE, KY 40202-5700
(502) 588-4400
Mailing address
500 S PRESTON ST, ROOM 305, LOUISVILLE, KY 40202-1702
(502) 852-8696
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
TP034
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100606440
—
KY
Enumeration date
04/06/2017
Last updated
08/28/2022
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