Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 02485 | KY |
Y | 207V00000X | Obstetrician & Gynecologist | 02485 | KY |
N | 207VE0102X | Reproductive Endocrinologist | 02485 | KY |
N | 208D00000X | General Practice Physician | 02485 | KY |
NPI | 1275505364 |
---|---|
Provider Name | George Michael Veloudis JR. |
First Address | Lexington, KY 40509-9087 |
Second Address | Lexington, KY 40509-9087 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 08/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02485 | KY LICENSE (01) | KY |
1275547606 | (05) | KY |
64024854 | (05) | KY |
7100107450 | (05) | KY |
BV3608114 | DEA (01) | KY |
G10500 | (02) |