Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 18531 | KY |
N | 2084N0402X | Child Neurologist | 18531 | KY |
NPI | 1336126515 |
---|---|
Provider Name | Dr. James E Mckiernan |
First Address | Louisville, KY 40295-0248 |
Second Address | Louisville, KY 40207-4660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 13/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000617819 | ANTHEM (01) | KY |
100373820 | (05) | IN |
1049109 | PASSPORT (01) | KY |
2432390000 | PASSPORT ADVANTAGE (01) | KY |
64185317 | (05) | KY |
C66250 | (02) | |
P00719572 | RAILTOAD MEDICARE (01) | KY |