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General NPI Number Information
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NPI Number | 1861999252
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Entity Type | Individual
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Provider Name | JESSICA SUE GABRIELLE FORD DO
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Gender | Female
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 800 ROSE ST FL 1
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City | LEXINGTON
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State | KY
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Zip | 40536-8721
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Country | US
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Telephone | 859-562-1085
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Fax | 859-257-5152
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Provider Business Mailing Address
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Address Line | PO BOX 776879
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City | CHICAGO
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State | IL
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Zip | 60677-6879
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 05023
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 05023
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | OS21268
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License Number State | FL
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