Individual
DR. JEFFREY B HARGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3991 DUTCHMANS LN, SUITE 405, LOUISVILLE, KY 40207-4700
(502) 899-3366
(502) 899-3455
Mailing address
315 E BROADWAY, LOUISVILLE, KY 40202-3700
(502) 629-2500
(502) 629-2055
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
01044991
IN
207RH0003X
Hematology & Oncology Physician
Primary
32014
KY
207RH0003X
Hematology & Oncology Physician
35-05-2939-H
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051748
ANTHEM
—
01
—
1068542
PASSPORT
—
05
—
200101660A
—
IN
05
—
64320146
—
KY
01
—
830005454
RAILROAD MEDICARE
—
Enumeration date
02/09/2006
Last updated
01/19/2021
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