| Jason Samuel Chartered | |
|
110 Third St Suite 310 Henderson KY 42420 | |
| (270) 826-1266 | |
| (270) 827-5385 |
| Full Name | Jason Samuel Chartered |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 110 Third St, Henderson, Kentucky |
| Authorized Official Name and Position | Jason T Samuel (PRESIDENT) |
| Authorized Official Contact | 2708261266 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Samuel Chartered Po Box 1247 Henderson KY 42420 Ph: (270) 826-1266 | Jason Samuel Chartered 110 Third St Suite 310 Henderson KY 42420 Ph: (270) 826-1266 |
| NPI Number | 1629143342 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 05/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629143342 | NPI | - | NPPES |
| 7100038670 | Medicaid | KY | |
| 200893090A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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