(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003479593
Provider Name: JENCI LYN HAWTHORNE MEDICAL STUDENT, MD
Entity Type: Individual
Taxonomy Code: 390200000X
Specialty: Student in an Organized Health Care Education/Training Program
License Number:
Most Important Dates
Enumeration Date: 04/19/2019
Last Updated: 05/06/2021
Provider Practice Location
500 S PRESTON ST RM 305
LOUISVILLE
KY
402021702
Practice Location Phone/Fax
Phone: 5028528696
Fax:
Provider Mailing Location
550 S JACKSON ST FL 2
LOUISVILLE
KY
402021622
Provider Mailing Phone/Fax
Phone: 5025617448
Fax: