Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JASEN THOMAS PEDERSEN, DPM
Active Sole ProprietorDR. JASEN THOMAS PEDERSEN, DPM is a Foot & Ankle Surgery Podiatrist healthcare provider located in CRESTWOOD, Kentucky. NPI 1114182326 is currently active in the NPPES registry. Verify at CMS.
Foot & Ankle Surgery Podiatrist · CRESTWOOD, KY
Registration Details
- NPI Number
- 1114182326
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 28, 2008 (18.028843577549 yrs)
- Last Updated
- Apr 27, 2020
- Licenses
-
243971 (KY)243971 (KY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6400 WESTWIND WAYSUITE BCRESTWOOD, KY, 400146773Browse KY providers · Browse ZIP 40014
- Phone
- 5022769999
- Fax
- 5022769999
- Primary Specialty
-
Foot & Ankle Surgery Podiatrist
213ES0103X
- Additional Specialty
- Foot & Ankle Surgery Podiatrist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.