Provider Demographics
NPI:1265436026
Name:SONGER, JESS DANIEL (DPM)
Entity type:Individual
Prefix:DR
First Name:JESS
Middle Name:DANIEL
Last Name:SONGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 29TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-3019
Mailing Address - Country:US
Mailing Address - Phone:606-324-1994
Mailing Address - Fax:606-324-2274
Practice Address - Street 1:841 29TH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-3019
Practice Address - Country:US
Practice Address - Phone:606-324-1994
Practice Address - Fax:606-324-2274
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY118213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist