Individual
DR. MARY E FALLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
234 E GRAY ST, STE 766, LOUISVILLE, KY 40202-1901
(502) 588-0390
(502) 584-5437
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0390
(502) 584-5437
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
21050
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100330770
—
IN
05
—
64210503
—
KY
Enumeration date
07/05/2005
Last updated
10/14/2020
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