Provider Demographics
NPI:1811253628
Name:KAPP, JONATHAN CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CHRISTOPHER
Last Name:KAPP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:210 E GRAY ST STE 700
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3903
Practice Address - Country:US
Practice Address - Phone:502-629-5400
Practice Address - Fax:502-629-5492
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2022-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY48065207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100261520Medicaid
KY7100261520Medicaid