Individual
TROY K TAKAGISHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3991 DUTCHMANS LN STE 211, LOUISVILLE, KY 40207-4723
(502) 899-6061
(502) 899-6127
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 272-5100
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.122220
IL
207RR0500X
Rheumatology Physician
Primary
TP865
KY
208000000X
Pediatrics Physician
036.122220
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201033700
—
IN
01
—
50033886
PASSPORT- NORTON RHEUMATOLOGY SPECIALISTS
KY
05
—
7100170030
—
KY
01
—
P00992208
RAILROAD MEDICARE
KY
Enumeration date
07/03/2008
Last updated
02/06/2012
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