Provider Demographics
NPI:1477628337
Name:KAYE, JASON N (DC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:N
Last Name:KAYE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE C 130
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068
Mailing Address - Country:US
Mailing Address - Phone:770-565-2313
Mailing Address - Fax:770-565-8733
Practice Address - Street 1:736 JOHNSON FERRY RD
Practice Address - Street 2:SUITE C 130
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068
Practice Address - Country:US
Practice Address - Phone:770-565-2313
Practice Address - Fax:770-565-8733
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006299111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFRKMedicare ID - Type Unspecified