Organization
WESTPORT VILLAGE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESA SUTTON-DAVIS MD (OWNER)
(502) 412-0597
Entity
Organization
Contact information
Practice address
8134 NEW LAGRANGE RD, STE 100, LOUISVILLE, KY 40222-4676
(502) 412-0597
Mailing address
8134 NEW LAGRANGE RD, STE 100, LOUISVILLE, KY 40222-4676
(502) 412-0597
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36607
KY
Other
Enumeration date
11/08/2008
Last updated
11/08/2008
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