Individual
DR. JESSICA JAYA KOTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 897-8141
Mailing address
PO BOX 6749, LOUISVILLE, KY 40206-0749
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
52602
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52602
STATE LICENSE
KY
05
—
7100497030
—
KY
01
—
K289881
MEDICARE
KY
Enumeration date
03/27/2016
Last updated
03/25/2026
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