DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JAISE THEKKAN POULOSE, M.D.

Active

JAISE THEKKAN POULOSE, M.D. is a Critical Care Medicine healthcare provider located in EDGEWOOD, Kentucky. NPI 1497872675 is currently active in the NPPES registry. Verify at CMS.

Critical Care Medicine · EDGEWOOD, KY

Registration Details

NPI Number
1497872675
Provider Type
Individual
Gender
Male
NPI Issued
Mar 23, 2007 (19.403975557781 yrs)
Last Updated
Aug 6, 2025
Licenses
11150 (ND)
50104 (MN)
MD.207663 (LA)
53941 (KY)

Practice Information

Address
1 MEDICAL VILLAGE DR
EDGEWOOD, KY, 410173403
Browse KY providers · Browse ZIP 41017
Phone
8597572927
Fax
8593410203
Primary Specialty
Critical Care Medicine
207RC0200X
Additional Specialty
Critical Care Medicine
Additional Specialty
Pulmonary Disease
Additional Specialty
Critical Care Medicine

Other Critical Care Medicine Providers in EDGEWOOD, KY

Name Credential NPI
DR. RYAN GARNER MIHATA MD 1760466726
DR. HANI MURAD M.D. 1982610069
ABAYOMI OGUNDERU MD 1346656741
SAMINDER SINGH KALRA MD 1558746404
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.