Provider Demographics
NPI:1083064968
Name:KALMA, JEREMY (MD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:KALMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 NICHOLASVILLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1410
Mailing Address - Country:US
Mailing Address - Phone:859-899-7950
Mailing Address - Fax:859-260-5150
Practice Address - Street 1:1760 NICHOLASVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1410
Practice Address - Country:US
Practice Address - Phone:859-899-7950
Practice Address - Fax:859-260-5150
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY56762207X00000X, 207XX0004X
MI4301117434207X00000X
CODR.0065760207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100835080Medicaid