Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 01082600A | IN |
NPI | 1033564166 |
---|---|
Provider Name | Dr. Kevin Carter Andres |
First Address | Louisville, KY 40202-1675 |
Second Address | Louisville, KY 40202-1675 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2016 |
Last Update Date | 22/07/2020 |