Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 8152 | KY |
NPI | 1013058387 |
---|---|
Provider Name | Dr. Georgios Papageorgakopoulos |
First Address | Louisville, KY 40206-2146 |
Second Address | Louisville, KY 40292-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 08/07/2007 |