Provider Demographics
NPI:1366708620
Name:JAEGER, JOHN SEBASTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SEBASTIAN
Last Name:JAEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:SEBASTIAN
Other - Last Name:JAEGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8815 GERMANTOWN AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-2722
Mailing Address - Country:US
Mailing Address - Phone:215-248-8145
Mailing Address - Fax:
Practice Address - Street 1:938 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001
Practice Address - Country:US
Practice Address - Phone:267-620-0237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD463402207Q00000X
PAMT-209698207Q00000X
VA00000000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery