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General NPI Number Information
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NPI Number | 1801011440
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Entity Type | Individual
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Provider Name | JENNIFER PAGE DAILY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 12/18/2017
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Provider Practice Location Address
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Address Line | 501 E BROADWAY STE 240
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City | LOUISVILLE
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State | KY
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Zip | 40202-1798
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Country | US
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Telephone | 502-588-8700
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 909
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City | LOUISVILLE
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State | KY
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Zip | 40201
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Country | US
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Telephone | 502-588-8700
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2009007059
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 47485
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 2009007059
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 47485
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License Number State | KY
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