Individual
DR. JANE ELLEN CORNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
676 S FLOYD ST STE 200, LOUISVILLE, KY 40202-1840
(502) 629-2806
(502) 629-2809
Mailing address
PO BOX 776347, CHICAGO, IL 60677-6347
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25867
KY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
25867
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000625204
ANTHEM
KY
05
—
64258676
—
KY
Enumeration date
09/21/2006
Last updated
10/13/2020
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