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General NPI Number Information
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NPI Number | 1215993209
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Entity Type | Individual
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Provider Name | JEFFREY S DANETZ MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 1325 TRIPLETT ST
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City | OWENSBORO
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State | KY
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Zip | 42303-3163
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Country | US
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Telephone | 270-688-4325
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Fax | 270-687-4322
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Provider Business Mailing Address
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Address Line | PO BOX 23229
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City | OWENSBORO
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State | KY
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Zip | 42304-3229
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Country | US
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Telephone | 270-688-1330
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Fax | 270-688-1338
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 47741
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | TP082
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME93263
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | TP082
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License Number State | KY
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