Provider Demographics
NPI:1265482426
Name:SAINT-JACQUES, CLAUDE E (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:E
Last Name:SAINT-JACQUES
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 1:617 OLD SYMSONIA RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-5042
Mailing Address - Country:US
Mailing Address - Phone:270-527-2411
Mailing Address - Fax:270-527-8734
Practice Address - Street 1:617 OLD SYMSONIA RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-5042
Practice Address - Country:US
Practice Address - Phone:270-527-2411
Practice Address - Fax:270-527-8734
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24325207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000496111OtherBLUE CROSS AND BLUE SHIEL
KYP00134537OtherRR MEDICARE
KY610601267OtherCOMMERCIAL
KY64243256Medicaid
KY000000496111OtherBLUE CROSS AND BLUE SHIEL
KY610601267OtherCOMMERCIAL