Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 49774 | KY |
NPI | 1346506052 |
---|---|
Provider Name | Joseph L Laratta |
First Address | Louisville, KY 40202-1711 |
Second Address | Louisville, KY 40217-1412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 03/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300009400 | (05) | IN |
7100485470 | (05) | KY |