Dr Jerry William San Diego, MD - Pathology in Leavenworth, KS

Dr Jerry William San Diego, MD is a Pathology - Anatomic Pathology & Clinical Pathology physician based in Leavenworth, Kansas. Dr Jerry William San Diego is licensed to practice in Louisiana (license number 024399) and his current practice location is 4101 S 4th St, P And Lms, Leavenworth, Kansas. He can be reached at his office (for appointments etc.) via phone at (913) 682-2000.

NPI number for Dr Jerry William San Diego is 1285694604 and his current mailing address is 4101 S 4th St, P And Lms, Leavenworth, Kansas. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1285694604.

Contact Information

Dr Jerry William San Diego, MD
4101 S 4th St, P And Lms,
Leavenworth, KS 66048-5014
(913) 682-2000
(913) 758-4193



Physician's Profile

Full NameDr Jerry William San Diego
GenderMale
SpecialityPathology - Anatomic Pathology & Clinical Pathology
Location4101 S 4th St, Leavenworth, Kansas
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1285694604
  • Provider Enumeration Date: 03/28/2006
  • Last Update Date: 08/04/2014

Medical Identifiers

Medical identifiers for Dr Jerry William San Diego such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1285694604NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207ZP0102XPathology - Anatomic Pathology & Clinical Pathology 024399 (Louisiana)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jerry William San Diego is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jerry William San Diego, MD
4101 S 4th St, P And Lms,
Leavenworth, KS 66048-5014

Ph: (913) 682-2000
Dr Jerry William San Diego, MD
4101 S 4th St, P And Lms,
Leavenworth, KS 66048-5014

Ph: (913) 682-2000

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Pathology Doctors in Leavenworth, KS

Yung Park,
Pathology
Medicare: Not Enrolled in Medicare
Practice Location: 4101 S 4th St, Leavenworth, KS 66048
Phone: 913-682-2000    

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