Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 13630 | KY |
NPI | 1649372806 |
---|---|
Provider Name | Dr. Morton Lee Kasdan |
First Address | Louisville, KY 40206-0048 |
Second Address | Louisville, KY 40207-4905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C63297 | (02) | KY |