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General NPI Number Information
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NPI Number | 1053968107
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Entity Type | Individual
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Provider Name | JACOB J DINGESS
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Gender | Male
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 800 ZORN AVE
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City | LOUISVILLE
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State | KY
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Zip | 40206-1433
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Country | US
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Telephone | 502-287-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 SPRING VALLEY DR
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City | HUNTINGTON
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State | WV
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Zip | 25704-9300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 020876
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License Number State | KY
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