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NPI Code Detail

MEDICARE: DR. JON STANLEY DEMOS MD

MEDICARE: DR. JON STANLEY DEMOS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician21889KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548266026
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JON STANLEY DEMOS MD
Provider Business Mailing Address
First Line : 1101 VETERANS DR.
Second Line : RM A509A -CDD, DEPT. OF VETERANS AFFAIRS,
City : LEXINGTON
State : KY
Zip : 40502-2236
Country : US
Telephone Number : 859-281-4964
Fax Number : 859-381-5824
Provider Business Practice Location Address
First Line : 1101 VETERANS DR
Second Line : RM A509A-CDD
City : LEXINGTON
State : KY
Zip : 40502-2235
Country : US
Telephone Number : 859-281-4964
Fax Number : 859-381-5824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 03/10/2011

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