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Individual

DANILO JOSON CALDERON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
525 ALEXANDRIA PIKE, SUITE 300, SOUTHGATE, KY 41071
(859) 781-2210
(859) 781-0289
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 781-2210
(859) 781-0289

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39739
CO
207R00000X
Internal Medicine Physician
Primary
42066
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2966554
OH
05
7100069240
KY
01
P00637558
MEDICARE RAILROAD
KY
01
P00839839
RAILROAD MEDICARE
KY
Enumeration date
07/13/2006
Last updated
01/25/2023
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