Basic Information
| Provider Information | |||||||||
| NPI: | 1447424965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KERN | ||||||||
| FirstName: | JARED | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4100 LAKE OTIS PKWY | ||||||||
| Address2: | SUITE 312 | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995085229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075693668 | ||||||||
| FaxNumber: | 9075693669 | ||||||||
| Practice Location | |||||||||
| Address1: | 4100 LAKE OTIS PKWY | ||||||||
| Address2: | SUITE 312 | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995085229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075693668 | ||||||||
| FaxNumber: | 9075693669 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2008 | ||||||||
| LastUpdateDate: | 05/25/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | MED D 6023 | AK | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 213ES0103X | PO 60017003 | WA | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.