Individual
MANISHA JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
427 US 31W BYP, BOWLING GREEN, KY 42101-1703
(270) 796-8000
(270) 796-8000
Mailing address
PO BOX 90039, BOWLING GREEN, KY 42102-9039
(270) 796-8000
(270) 796-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
45475
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45475
LICENSE
KY
05
—
7100230230
—
KY
Enumeration date
01/26/2007
Last updated
12/13/2013
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