Individual
DR. ILDEFONSO A CAMPOMANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
332 W BROADWAY, LOUISVILLE, KY 40202-2130
(502) 583-0909
(502) 583-0913
Mailing address
332 W BROADWAY, LOUISVILLE, KY 40202-2133
(502) 583-0909
(502) 583-0913
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
16720
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64167208
—
KY
Enumeration date
05/19/2006
Last updated
10/17/2007
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