Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 20348 | KY |
NPI | 1013913037 |
---|---|
Provider Name | Karen Duckwall |
First Address | Louisville, KY 40212-1033 |
Second Address | Louisville, KY 40212-1033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 18/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000338413 | ANTHEM (01) | KY |
64203482 | (05) | KY |
C74486 | (02) | KY |