Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 18655 | KY |
NPI | 1134112543 |
---|---|
Provider Name | James W Forrester |
First Address | Louisville, KY 40223-5132 |
Second Address | Louisville, KY 40207-4806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 02/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6418655400 | (05) | KY |
C66559 | (02) | KY |