Segeleon, Jennifer Logan

Segeleon, Jennifer Logan is an individual health care provider with primary practice located at 100 Mallard Creek Rd Ste 395 , Louisville KY 40207-5167. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Segeleon, Jennifer Logan can be contacted via phone (502) 895-9421.

Contact Information

Primary practice address
100 Mallard Creek Rd Ste 395 Louisville KY 40207-5167
Phone: (502) 895-9421
Fax: (502) 899-5762
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 37791 Kentucky

Profile Details

NPI number 1588662787
LBN Legal business name Segeleon, Jennifer Logan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Jan 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588662787 NPPES
Kentucky Other 138722 SIHO - KCMA
Kentucky MEDICAID 7100133960 SIHO - KCMA
Kentucky Other 50039818 SIHO - KCMA
Kentucky Other 000000777755 SIHO - KCMA

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