Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 348 | KY |
NPI | 1063611952 |
---|---|
Provider Name | Angela Binns Didyk |
First Address | Louisville, KY 40223 |
Second Address | Louisville, KY 40223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 13/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6337270001 | PTAN (01) | KY |