Individual
DR. JODIE LUSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4010 DUPONT CIR STE 524, ST MATTHEWS, KY 40207-4888
(502) 897-9417
Mailing address
11400 WILLOW BRANCH DR, LOUISVILLE, KY 40291-4529
(859) 816-2701
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
9779
KY
Other
Enumeration date
04/11/2016
Last updated
06/23/2019
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