Provider Demographics
NPI:1124207378
Name:HARRIS, JASON SANDLIN (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:SANDLIN
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1725 HARRODSBURG RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3601
Mailing Address - Country:US
Mailing Address - Phone:859-278-7226
Mailing Address - Fax:859-278-4382
Practice Address - Street 1:1725 HARRODSBURG RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3601
Practice Address - Country:US
Practice Address - Phone:859-278-7226
Practice Address - Fax:859-278-4382
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2012-11-20
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Provider Licenses
StateLicense IDTaxonomies
OH570139082085R0202X
VA01012475372085R0202X
KY444212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology