Healthcare Provider Details

I. General information

NPI: 1245256270
Provider Name (Legal Business Name): JASON S HARROD DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 10/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 YORKSHIRE MEDICAL PARK
LEXINGTON KY
40509
US

IV. Provider business mailing address

3480 YORKSHIRE MEDICAL PARK
LEXINGTON KY
40509
US

V. Phone/Fax

Practice location:
  • Phone: 859-263-5140
  • Fax: 859-263-5141
Mailing address:
  • Phone: 859-263-5140
  • Fax: 859-263-5141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number00262
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00262
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: