Provider Demographics
NPI:1629198593
Name:KAIGH, JODI (MD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:
Last Name:KAIGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2927
Mailing Address - Country:US
Mailing Address - Phone:307-234-7400
Mailing Address - Fax:307-234-7474
Practice Address - Street 1:1204 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2927
Practice Address - Country:US
Practice Address - Phone:307-234-7400
Practice Address - Fax:307-234-7474
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5952A207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYE43802Medicare UPIN
WY307548Medicare ID - Type Unspecified