Provider Demographics
NPI:1689990558
Name:PAISLEY, JENNIFER RAE (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RAE
Last Name:PAISLEY
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-344-5555
Mailing Address - Fax:859-344-5552
Practice Address - Street 1:98 ELM ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2048
Practice Address - Country:US
Practice Address - Phone:812-537-4999
Practice Address - Fax:812-537-5710
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01087421A207RB0002X, 208000000X, 207R00000X
IAMD42001208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics