Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 2901009195 | MD |
Y | 1223P0106X | Oral and Maxillofacial Pathology | 8565 | KY |
NPI | 1497838262 |
---|---|
Provider Name | Dr. John J Sauk |
First Address | Louisville, KY 40202-1701 |
Second Address | Louisville, KY 40202-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 18/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
190003329 | RAILROAD MEDICARE (01) | MD |
418538200 | (05) | MD |
U27469 | (02) | MD |