Provider Demographics
NPI:1609561737
Name:BARTOW, JADAH CORINN (MD)
Entity Type:Individual
Prefix:
First Name:JADAH
Middle Name:CORINN
Last Name:BARTOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JADAH
Other - Middle Name:CORINN
Other - Last Name:THAEMERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5208 S YARROW TRL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2901
Mailing Address - Country:US
Mailing Address - Phone:605-321-2680
Mailing Address - Fax:
Practice Address - Street 1:1400 W 22ND ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1554
Practice Address - Country:US
Practice Address - Phone:505-322-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program