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Individual

DR. JANSEN CRAIG DIENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 W MAIN ST, NCT 20, LOUISVILLE, KY 40202-2946
(502) 580-4070
(502) 508-4070
Mailing address
500 W MAIN ST, NCT 20, LOUISVILLE, KY 40202-2946
(502) 580-4070
(502) 508-4070

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101244204
VA
207Q00000X
Family Medicine Physician
01065419A
IN
207Q00000X
Family Medicine Physician
Primary
23832
KY

Other

Enumeration date
02/04/2011
Last updated
02/04/2011
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