Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 07001246A | IN |
Y | 213ES0103X | Foot & Ankle Surgery | 243992 | KY |
NPI | 1083029235 |
---|---|
Provider Name | Dr. Christopher Carl Saccone |
First Address | Louisville, KY 40219-3971 |
Second Address | Elizabethtown, KY 42701-7933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 15/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300004224 | (05) | IN |
7100466340 | (05) | KY |