Provider Demographics
NPI:1801510094
Name:KAUR, JAGJIT (PA-C)
Entity type:Individual
Prefix:
First Name:JAGJIT
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3266 N MERIDIAN ST STE 501
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5857
Mailing Address - Country:US
Mailing Address - Phone:317-925-0653
Mailing Address - Fax:
Practice Address - Street 1:3266 N MERIDIAN ST STE 501
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5857
Practice Address - Country:US
Practice Address - Phone:317-925-0653
Practice Address - Fax:317-854-7767
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10003737A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant