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Individual

LANNY R GORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2125 STATE ST, SUITE 3, NEW ALBANY, IN 47150
(812) 542-1203
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4917
(502) 489-5751

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01062140
IN
208600000X
Surgery Physician
51638
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200850230
IN
Enumeration date
12/12/2006
Last updated
06/25/2018
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