Individual
MICHAEL J. PHYTHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1025 NEW MOODY LN, LA GRANGE, KY 40031-9154
(502) 222-3886
Mailing address
9919 SHINING WILLOW DR APT 102, LOUISVILLE, KY 40241-3152
(734) 306-9822
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28217658A
IN
367500000X
Certified Registered Nurse Anesthetist
105991
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
28217658A
IN
367500000X
Certified Registered Nurse Anesthetist
3015571
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300019427
—
IN
05
—
7100736760
—
KY
Enumeration date
09/18/2014
Last updated
10/09/2025
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