Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | ME53220 | FL |
Y | 207RA0401X | Internist - Addiction Medicine | TP426 | KY |
NPI | 1831388073 |
---|---|
Provider Name | Jonathan D Kunis |
First Address | Louisville, KY 40223-3818 |
Second Address | Louisville, KY 40223-3818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 23/04/2018 |