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LARRY TRAVIS LAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 ABRAHAM FLEXNER WAY, ANESTHESIA DEPARTMENT, LOUISVILLE, KY 40202-1886
(502) 587-4404
(502) 587-4156
Mailing address
57 INDIAN HILLS TRL, LOUISVILLE, KY 40207-1530
(859) 539-2817

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35-123772
OH
207L00000X
Anesthesiology Physician
Primary
39406
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200863510A (KOHMG)
IN
05
64111420 (KOHMG)
KY
01
K121540-KOHMG
MEDICARE
KY
01
P01567905-KOHMG
RR MEDICARE
KY
Enumeration date
09/30/2006
Last updated
05/01/2019
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