Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 52137 | KY |
N | 208600000X | Surgeon | 52137 | KY |
N | 208200000X | Surgeon | 62045 | TN |
N | 208600000X | Surgeon | 62045 | TN |
Y | 2082S0105X | Plastic Hand Surgeon | 52137 | KY |
N | 2082S0105X | Plastic Hand Surgeon | 62045 | TN |
NPI | 1851659981 |
---|---|
Provider Name | Haiqiao Jiao |
First Address | Louisville, KY 40202-3868 |
Second Address | Louisville, KY 40202-3868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2012 |
Last Update Date | 01/07/2021 |