Doctor Name: | DR. KRISHNA MOHAN JAIN |
NPI Number: | 1013972769 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 4301043579 |
Business Practice Address: | 1815 Henson Ave Kalamazoo, MI - 490481510 |
Business Phone Number: | 2694926500 |
Business Fax Number: | 2694926461 |
Mailing Address: | 1815 Henson Ave, KALAMAZOO |
State: | MI |
Postal Code: | 490481510 |
Phone Number: | 2694926500 |
Fax Number: | 2694926461 |
NPI Enumeration Date: | 04/18/2006 |
NPI Last Update Date: | 04/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | 4301043579 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |