Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | TP558 | KY |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 40202 | KY |
NPI | 1720002207 |
---|---|
Provider Name | Thomas W Mckain |
First Address | Louisville, KY 40205-3224 |
Second Address | Louisville, KY 40205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 31/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
50015951 | PASSPORT (01) | KY |
64080377 | (05) | KY |
C24737 | (02) |