Provider Demographics
NPI:1447424965
Name:KERN, JARED (DPM)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:KERN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4100 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 312
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5229
Mailing Address - Country:US
Mailing Address - Phone:907-569-3668
Mailing Address - Fax:907-569-3669
Practice Address - Street 1:4100 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 312
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5229
Practice Address - Country:US
Practice Address - Phone:907-569-3668
Practice Address - Fax:907-569-3669
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AKMED D 6023213ES0103X
WAPO 60017003213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery