| NPI | 1780817502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA L BAKER Credentialing Coordinator 502-893-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251X0800X Physical Therapist, Orthopedic | |
| 231H00000X Audiologist | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 2085R0001X Radiology, Radiation Oncology | |
| 363L00000X Nurse Practitioner | |
| 207K00000X Allergy & Immunology | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2023-12-18 |