Organization
SOUTHEND GASTROENTEROLOGY ASSOCIATES PLLC
Active
Organization
SOUTHEND GASTROENTEROLOGY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY K JAIN MD (OWNER)
(502) 891-4000
Entity
Organization
Contact information
Practice address
4402 CHURCHMAN AVE, STE 408, LOUISVILLE, KY 40215-1190
(502) 365-5140
Mailing address
2503 BUSH RIDGE DR, A, LOUISVILLE, KY 40245-5885
(502) 819-4000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000644156
ANTHEM
—
05
—
201118680
—
IN
01
—
50027327
PASSPORT
KY
05
—
7100101260
—
KY
01
—
7956992
AETNA
—
Enumeration date
12/16/2009
Last updated
05/17/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up