Individual
DR. NORMAN D RADTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 AUDUBON PLAZA DR, SUITE 240, LOUISVILLE, KY 40217-1319
(502) 636-2823
(502) 634-1646
Mailing address
3 AUDUBON PLAZA DR, SUITE 240, LOUISVILLE, KY 40217-1319
(502) 636-2823
(502) 634-1646
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01035488
IN
207W00000X
Ophthalmology Physician
Primary
20988
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047621
ANTHEM
KY
05
—
100003470A
—
IN
05
—
100003470B
—
IN
05
—
100003470D
—
IN
05
—
64209885
—
KY
Enumeration date
08/03/2005
Last updated
08/26/2020
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