Individual
KEVIN L HARRELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4402 CHURCHMAN AVE, SUITE 300, LOUISVILLE, KY 40215-1190
(502) 363-0588
(502) 363-0972
Mailing address
6801 DIXIE HWY, SUITE 130, LOUISVILLE, KY 40258-3913
(502) 363-0588
(502) 363-0972
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
44601
KY
207X00000X
Orthopaedic Surgery Physician
ME105941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018911600
—
FL
01
—
147QS
BCBS
FL
05
—
7100192290
—
KY
Enumeration date
10/03/2007
Last updated
06/21/2012
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