Individual
KODUVATHARA L JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 ABRAHAM FLEXNER WAY, SUITE 305, LOUISVILLE, KY 40202-1882
(502) 585-4321
(502) 566-6338
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 585-4321
(502) 566-6338
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01033493A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
23622
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060026550
RAILROAD MEDICARE
IN
01
—
060057271
RAILROAD MEDICARE
KY
05
—
100075640
—
IN
05
—
64756406
—
KY
01
—
P00141381
RAILROAD MEDICARE
KY
Enumeration date
10/06/2005
Last updated
04/02/2018
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