Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 26914 | KY |
NPI | 1013930635 |
---|---|
Provider Name | Stanley A. Gall |
First Address | Louisville, KY 40202-1622 |
Second Address | Louisville, KY 40202-1622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 25/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000045428 | ANTHEM PSC (01) | KY |
000000047614 | ANTHEM - FOUNDATION (01) | KY |
100365150A | (05) | IN |
1049237 | PASSPORT PCP - FOUNDATION (01) | KY |
1049275 | PASSPORT SPECIALITY - PSC (01) | KY |
1050108 | PASSPORT SPECIALITY - FOUNDATION (01) | KY |
64269145 | (05) | KY |
C83948 | (02) | KY |