Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 238138 | NY |
N | 207X00000X | Orthopaedic Surgeon | 238138 | NY |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 03167 | KY |
N | 207XS0117X | Orthopaedic Spine Surgeon | 238138 | NY |
NPI | 1629014675 |
---|---|
Provider Name | Dr. Karen Avanesov |
First Address | Louisville, KY 40202-3900 |
Second Address | Louisville, KY 40202-3900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 06/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000628579 | ANTHEM- NORTON LEATHERMAN SPINE CENTER (01) | KY |
000051983P | HUMANA- NORTON LEATHERMAN SPINE CENTER (01) | KY |
00533170 | ADVANTRA FREEDOM- NORTON LEATHERMAN SPINE CENTER (01) | KY |
200952070 | (05) | IN |
200952070 | HEALTHY INDIANA PLAN- NORTON LEATHERMAN SPINE CENTER (01) | KY |
200952070 | SIHO- NORTON LEATHERMAN SPINE CENTER (01) | KY |
3740627000 | PASSPORT ADVANTAGE- NORTON LEATHERMAN SPINE CENTER (01) | KY |
50025970 | PASSPORT- NORTON LEATHERMAN SPINE CENTER (01) | KY |
7100084130 | (05) | KY |