Provider Demographics
NPI:1316387665
Name:MALAN, JARED RICK (DPM)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:RICK
Last Name:MALAN
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Gender:M
Credentials:DPM
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Mailing Address - Street 1:420 LORETTO RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-1628
Mailing Address - Country:US
Mailing Address - Phone:270-692-5272
Mailing Address - Fax:270-692-5285
Practice Address - Street 1:420 LORETTO RD
Practice Address - Street 2:SUITE 500
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-1628
Practice Address - Country:US
Practice Address - Phone:270-692-5272
Practice Address - Fax:270-692-5285
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2016-08-25
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Provider Licenses
StateLicense IDTaxonomies
PASC006481213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery