Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 12012589A | IN |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 9854 | KY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 9854 | KY |
NPI | 1053756502 |
---|---|
Provider Name | Alexander Musser |
First Address | Louisville, KY 40219-4056 |
Second Address | Louisville, KY 40219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2013 |
Last Update Date | 21/06/2018 |