Individual
JASEENA ELIKKOTTIL
Active
Individual
JASEENA ELIKKOTTIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49109
KY
208M00000X
Hospitalist Physician
49109
KY
246RH0600X
Histology Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
22544
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201407600
—
IN
05
—
7100437200
—
KY
Enumeration date
03/06/2009
Last updated
08/03/2021
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