Organization
MIDDLETOWN PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANA J. DISTLER M.D. (PHYSICIAN/OWNER)
(502) 244-9858
Entity
Organization
Contact information
Practice address
301 C MIDDLETOWN PARK PLACE, LOUISVILLE, KY 40243
(502) 244-9858
(502) 244-9575
Mailing address
301 C MIDDLETOWN PARK PLACE, LOUISVILLE, KY 40243
(502) 244-9858
(502) 244-9575
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
28883
KY
2080A0000X
Pediatric Adolescent Medicine Physician
38964
KY
2080A0000X
Pediatric Adolescent Medicine Physician
39163
KY
Other
Enumeration date
04/11/2007
Last updated
03/12/2014
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