Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 14203 | KY |
NPI | 1174669469 |
---|---|
Provider Name | Gerald Francis Sturgeon |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40207-4812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 22/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000074843 | ANTHEM BLUE CROSS BLUE SH (01) | KY |
000000074843 | PASSPORT HEALTH PLAN KY (01) | KY |
000000739398 | ANTHEM - KCMA (01) | KY |
129358 | SIHO - KCMA (01) | KY |
4012913 | AETNA (01) | KY |
50035680 | PASSPORT - KCMA (01) | KY |
64142037 | (05) | KY |
E01366 | (02) | KY |