Provider Demographics
NPI:1851509848
Name:DR. JEFF, INC
Entity Type:Organization
Organization Name:DR. JEFF, INC
Other - Org Name:FAMILY CARE CHIROPRACTIC FERN CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:LANSING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-231-3000
Mailing Address - Street 1:5712 BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-1914
Mailing Address - Country:US
Mailing Address - Phone:502-231-3000
Mailing Address - Fax:502-239-2446
Practice Address - Street 1:5712 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-1914
Practice Address - Country:US
Practice Address - Phone:502-231-3000
Practice Address - Fax:502-239-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1168198Medicaid
U92335KYMedicare UPIN
KY0732501Medicare ID - Type Unspecified