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Jackie R Kazee

Family Medicine

Allopathic & Osteopathic Physicians

1101 Saint Christopher Dr, Suite 250, Ashland, KY 41101-7087

PECOS Enrollment

This provider is enrolled in PECOS as JACKIE KAZEE.

Based on the most recent information from CMS, provider Jackie R Kazee is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 1:10 PM.

Profile Details

Provider ID
1679734693
Provider Type
Individual
Full Name
Kazee, Jackie R
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/23/2008
Last Updated
12/27/2011

Contact Information

Practice Location

1101 Saint Christopher Dr, Suite 250, Ashland, KY 41101-7087

(606) 836-3196

(606) 836-2564

Mailing Location

1101 Saint Christopher Dr, Suite 250, Ashland, KY 41101-7087

(606) 836-3196

(606) 836-2564

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 44622 Kentucky
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License TP001 Kentucky

Jackie R Kazee

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Jones, Derek W,

Detherage, James M

Sanjiv Gupta M.D. P.S.C.

Darnell, John Howard

Short, William Joseph

Brock, Michael E.

Ashland Hospital Corporation

Mcdaniel, Mark Elliott

Aim Wellness Llc

Ovp Health Care Inc