Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 51762 | KY |
Y | 207PP0204X | Pediatric Emergency Physician | 51762 | KY |
NPI | 1407111685 |
---|---|
Provider Name | Dr. Jaryd Kaufman Zummer |
First Address | Lexington, KY 40536-0298 |
Second Address | Lexington, KY 40536-0298 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2012 |
Last Update Date | 05/11/2018 |