Organization
NALLY FAMILY PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARI N NALLY MD (OWNER)
(502) 961-5970
Entity
Organization
Contact information
Practice address
11302 PRESTON HWY, LOUISVILLE, KY 40229-2862
(502) 961-5970
(502) 961-5980
Mailing address
11302 PRESTON HWY, LOUISVILLE, KY 40229-2862
(502) 961-5970
(502) 961-5980
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100160290
—
KY
01
—
K004941
MEDICARE PTAN
KY
Enumeration date
03/04/2011
Last updated
09/08/2011
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