Organization
G.I.M., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEON BUTLER MD (PRESIDENT)
(502) 435-1739
Entity
Organization
Contact information
Practice address
16605 CHESTNUT GLEN PL, LOUISVILLE, KY 40245-6121
(502) 709-0430
Mailing address
16605 CHESTNUT GLEN PL, LOUISVILLE, KY 40245-6121
(502) 709-0430
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3010352
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3010352
NURSE PRACTITIONER LICENSE NUMBER
KY
Enumeration date
08/01/2016
Last updated
08/01/2016
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