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Organization
CHUBINIDZEMD PLLC
Active
Organization
CHUBINIDZEMD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMARI CHUBINIDZE (OWNER)
(502) 244-5252
Entity
Organization
Contact information
Practice address
1306 OLD TAYLOR TRL, GOSHEN, KY 40026-9727
(502) 244-5252
Mailing address
1306 OLD TAYLOR TRL, GOSHEN, KY 40026-9727
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/07/2012
Last updated
07/17/2024
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