Provider Demographics
NPI:1124429253
Name:GROTH, JASON C (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:C
Last Name:GROTH
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Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:UK DIVISION OF HOSPITAL MEDICINE
Mailing Address - Street 2:800 ROSE STREET, MN604
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-6047
Mailing Address - Fax:859-257-3873
Practice Address - Street 1:UK DIVISION OF HOSPITAL MEDICINE
Practice Address - Street 2:800 ROSE STREET, MN604
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-6047
Practice Address - Fax:859-257-3873
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2015-05-08
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Provider Licenses
StateLicense IDTaxonomies
KYPA1924363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant