Provider Demographics
NPI:1578797395
Name:FELDER, JERROD J (MD)
Entity Type:Individual
Prefix:
First Name:JERROD
Middle Name:J
Last Name:FELDER
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 1:611 N LINDSAY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4300
Mailing Address - Country:US
Mailing Address - Phone:336-878-6520
Mailing Address - Fax:
Practice Address - Street 1:740 S. LIMESTONE STREET, K401 KENTUCKY CLINIC
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-218-3064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY47000207XX0005X
NC2015-01164207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine