Provider Demographics
NPI:1679734693
Name:KAZEE, JACKIE R (MD)
Entity type:Individual
Prefix:
First Name:JACKIE
Middle Name:R
Last Name:KAZEE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 SAINT CHRISTOPHER DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7087
Mailing Address - Country:US
Mailing Address - Phone:606-836-3196
Mailing Address - Fax:606-836-2564
Practice Address - Street 1:1101 SAINT CHRISTOPHER DR
Practice Address - Street 2:SUITE 250
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7087
Practice Address - Country:US
Practice Address - Phone:606-836-3196
Practice Address - Fax:606-836-2564
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2011-12-27
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Provider Licenses
StateLicense IDTaxonomies
KY44622207Q00000X
KYTP001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine