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Individual

RICHARD N GARRISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
401 E CHESTNUT ST, SUITE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
(502) 584-0302
Mailing address
401 E CHESTNUT ST, SUITE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
(502) 584-0302

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17065
KY
2086S0129X
Vascular Surgery Physician
17065
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100359210B
IN
01
1051113
PASSPORT
KY
05
64170657
KY
Enumeration date
05/09/2006
Last updated
07/30/2009
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