Basic Information
Provider Information
NPI: 1598746026
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JAEGER
FirstName: RANDY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108070366
Practice Location
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108070366
Other Information
ProviderEnumerationDate: 11/10/2005
LastUpdateDate: 12/13/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XMD050270LPAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
069778800001 INDEPENDENCE BLUE CROSSOTHER
217042301 MAMSIOTHER
75564201 HIGHMARK BLUE SHIELDOTHER
P0024787901 RAILROAD MEDICAREOTHER
5005319701 CAPITAL BLUE CROSSOTHER
916423801 PRIVATE HEALTHCARE SYSTEMOTHER
40520301 HEALTH AMERICA/HEALTH ASSOTHER
066018401 CIGNA HEALTHCAREOTHER
069778800001 AMERIHEALTHOTHER
82113001 FIRST PRIORITY HEALTHOTHER
4044001 GEISINGER HEALTH PLANOTHER
069778800001 KEYSTONE HEALTH EASTOTHER
5005319701 KEYSTONE HEALTH CENTRALOTHER
001458052000205PA MEDICAID
104942301 UNITED HEALTHCAREOTHER
432698101 AETNA PPOOTHER
P240731101 OXFORD HEALTH PLANSOTHER


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