| NPI | 1336269117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WORTLEY Executive Director 502-238-2801 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207Q00000X Family Medicine | |
| 208D00000X General Practice | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2010-08-03 |