Provider Demographics
NPI:1184763658
Name:NAU, JEFFREY C (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
Last Name:NAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3999 DUTCHMANS LN, SUITE #3A
Mailing Address - Street 2:SUBURBAN PLAZA ONE
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4714
Mailing Address - Country:US
Mailing Address - Phone:502-897-7300
Mailing Address - Fax:502-897-3332
Practice Address - Street 1:3999 DUTCHMANS LN, SUITE #3A
Practice Address - Street 2:SUBURBAN PLAZA ONE
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4714
Practice Address - Country:US
Practice Address - Phone:502-897-7300
Practice Address - Fax:502-897-3332
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY41958207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
9713169OtherAETNA
3542140000OtherPASSPORT ADVANTAGE
000000571084OtherCARESOURCE
097626OtherSHIO
4403029OtherCIGNA
118476358OtherGREATWEST
610889380OtherTRICARE
KY7100064910Medicaid
50020742OtherPASSPORT
KY0655204Medicare PIN
KY0655105Medicare PIN