| NPI | 1164445136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE DILLON Assistant Secretary 502-596-7220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207X00000X Orthopaedic Surgery | |
| 207P00000X Emergency Medicine | |
| 207R00000X Internal Medicine | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208600000X Surgery | |
| 363L00000X Nurse Practitioner | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2022-04-26 |