Individual
SANJAY K. JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4402 CHURCHMAN AVE STE 201, LOUISVILLE, KY 40215-3100
(502) 416-0207
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 416-0207
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
33212
KY
207RG0100X
Gastroenterology Physician
Primary
33212
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64880255
—
KY
01
—
P00424387
RAILROAD MEDICARE - KY
KY
Enumeration date
06/09/2006
Last updated
02/27/2025
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