Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D0068254 | MD |
N | 111NI0900X | Internist | D0068254 | MD |
Y | 207RC0000X | Internist - Cardiovascular Disease | 2020040971 | MO |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 01071122A | IN |
NPI | 1003018201 |
---|---|
Provider Name | Dr. Rahul Jain |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 11/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0060384 | (05) | OH |
200093348 | (05) | MO |
H076050 | MEDICARE PTAN (01) | OH |
P20347 | (02) | MD |