Dr Jerry William San Diego, MD is a
Pathology - Anatomic Pathology & Clinical Pathology physician based in Leavenworth, Kansas. Dr Jerry William San Diego is licensed to practice in Louisiana (license number 024399) and his current practice location is 4101 S 4th St, P And Lms, Leavenworth, Kansas. He can be reached at his office (for appointments etc.) via phone at
(913) 682-2000.
NPI number for Dr Jerry William San Diego is 1285694604 and his current mailing address is 4101 S 4th St, P And Lms, Leavenworth, Kansas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1285694604.
Physician's Profile
| Full Name | Dr Jerry William San Diego |
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| Gender | Male |
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| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
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| Location | 4101 S 4th St, Leavenworth, Kansas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1285694604
- Provider Enumeration Date: 03/28/2006
- Last Update Date: 08/04/2014
Medical Identifiers
Medical identifiers for Dr Jerry William San Diego such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1285694604 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 024399 (Louisiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jerry William San Diego is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jerry William San Diego, MD
4101 S 4th St, P And Lms,
Leavenworth, KS 66048-5014
Ph: (913) 682-2000 | Dr Jerry William San Diego, MD
4101 S 4th St, P And Lms,
Leavenworth, KS 66048-5014
Ph: (913) 682-2000 |
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