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Individual

DR. KENNETH R JAEGERS SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4121 DUTCHMANS LN, SUITE 410, LOUISVILLE, KY 40207-4707
(502) 897-9881
(502) 897-9824
Mailing address
2 RIVER HILL RD, LOUISVILLE, KY 40207-1191
(502) 896-1919

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13244
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13244
MEDICAL LICENSE
KY
05
6413244200
KY
Enumeration date
02/17/2006
Last updated
07/08/2007
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