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Individual

DR. APRIL RENEE MATTINGLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
7926 PRESTON HWY, SUITE 210, LOUISVILLE, KY 40219-3848
(502) 371-0022
(502) 394-3620
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
41600
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001008779
ANTHEM
KY
01
049330
SIHO
KY
05
200907180
IN
01
41600
KENTUCKY MEDICAL LICENSE
KY
01
50103506
PASSPORT
KY
05
7100044430
KY
Enumeration date
02/22/2007
Last updated
09/27/2022
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