Individual
DR. JASON C MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4950 NORTON HEALTHCARE BLVD STE 208, LOUISVILLE, KY 40241
(502) 614-4179
(502) 614-4450
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036120713
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
02004815A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
03604
KY
207RP1001X
Pulmonary Disease Physician
02004815A
IN
207RP1001X
Pulmonary Disease Physician
Primary
03604
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100236990
—
KY
Enumeration date
09/17/2008
Last updated
10/26/2020
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