Individual
MR. FRED JASON KIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1248 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-1854
(706) 863-0500
Mailing address
1248 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-1854
(706) 863-0500
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
026572
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00416446A
—
GA
01
—
52047422-001
BLUE CROSS BLUE SHIELD PR
GA
Enumeration date
08/30/2005
Last updated
07/08/2007
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