Individual
SUSAN BERSOT VINCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, ANESTHESIA DEPARTMENT, LOUISVILLE, KY 40202-1886
(502) 587-4404
(502) 587-4156
Mailing address
12912 DEER CROSS DR, PROSPECT, KY 40059-8118
(773) 343-1996
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
49408
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201384650A (KOHMG)
—
IN
05
—
7100249990 (KOHMG)
—
KY
Enumeration date
04/11/2012
Last updated
04/27/2018
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