Provider Demographics
NPI:1659786879
Name:CORNETT, JEFFREY CHASE (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CHASE
Last Name:CORNETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702-0959
Mailing Address - Country:US
Mailing Address - Phone:606-436-0711
Mailing Address - Fax:606-435-1322
Practice Address - Street 1:210 BLACK GOLD BLVD STE 106
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-2620
Practice Address - Country:US
Practice Address - Phone:606-436-0711
Practice Address - Fax:606-436-0848
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0116027455207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine