Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 3014959 | KY |
NPI | 1205580412 |
---|---|
Provider Name | James Chaney |
First Address | Louisville, KY 40203-4022 |
Second Address | Lexington, KY 40517-2121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2022 |
Last Update Date | 07/02/2022 |