Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JASON K FOGG, D.O.
ActivePain Medicine (PM&R) · HENDERSON, KY
Registration Details
- NPI Number
- 1831338151
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 10, 2009 (17.19147566441 yrs)
- Last Updated
- Nov 5, 2020
- Licenses
-
OT012163 (PA)03504 (KY)
Practice Information
- Address
-
1305 N ELM STHENDERSON, KY, 424202783Browse KY providers · Browse ZIP 42420
- Phone
- 2709578800
- Fax
- 2709578797
- Primary Specialty
-
Pain Medicine (PM&R)
2081P2900X
- Additional Specialty
- Pain Medicine (PM&R)
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.