Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD046014L | PA |
N | 208200000X | Surgeon | MD046014L | PA |
N | 208600000X | Surgeon | MD046014L | PA |
NPI | 1265469316 |
---|---|
Provider Name | Dr. Ashokkumar Babulal Jain |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 12/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014242050007 | (05) | PA |
01537411 | (05) | NY |
F59988 | (02) |