Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist | 26887 | KY |
N | 156FX1100X | Ophthalmic | 26887 | KY |
Y | 207W00000X | Ophthalmologist | KY26887 | KY |
NPI | 1609832542 |
---|---|
Provider Name | Peggy H Fishman |
First Address | Louisville, KY 40220-1330 |
Second Address | Louisville, KY 40220-1330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 19/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64870686 | (05) | KY |
E14739 | (02) | KY |