Individual
JACK THOMAS GIANNINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSC
Contact information
Practice address
220 W 18TH ST, HOPKINSVILLE, KY 42240-1963
(270) 886-7512
(270) 886-0174
Mailing address
220 W 18TH ST, HOPKINSVILLE, KY 42240-1963
(270) 886-7512
(270) 886-0174
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15869
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64158694
—
KY
Enumeration date
04/07/2006
Last updated
08/04/2014
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