Provider Demographics
NPI:1083688444
Name:GOLDEN, JEFFERY W (MD)
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:W
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 HOSPITAL WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2872
Mailing Address - Country:US
Mailing Address - Phone:606-451-2650
Mailing Address - Fax:606-451-2641
Practice Address - Street 1:350 HOSPITAL WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2872
Practice Address - Country:US
Practice Address - Phone:606-451-2650
Practice Address - Fax:606-451-2641
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY34227207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7922177OtherAETNA
C92455OtherCUMBERLAND HEALTHCARE
KY080178247OtherRAILROAD MEDICARE
1185380OtherCHA
000000213816OtherANTHEM
KY64016769Medicaid
5246814OtherCCN
C92455OtherCUMBERLAND HEALTHCARE
000000213816OtherANTHEM
KY64016769Medicaid