Provider Demographics
NPI:1366822306
Name:WARNER AND JANSEN PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:WARNER AND JANSEN PEDIATRICS, PLLC
Other - Org Name:WILKES AND WARNER PEDIATRICS, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-269-4604
Mailing Address - Street 1:3320 TATES CREEK RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3400
Mailing Address - Country:US
Mailing Address - Phone:859-269-4604
Mailing Address - Fax:859-266-0062
Practice Address - Street 1:3320 TATES CREEK RD
Practice Address - Street 2:SUITE 302
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3400
Practice Address - Country:US
Practice Address - Phone:859-269-4604
Practice Address - Fax:859-266-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty