Individual
MR. JAMES E EVERSOLE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 HIGH RISE DR, STE 374, LOUISVILLE, KY 40213-3252
(502) 969-6552
(502) 969-3799
Mailing address
2549 DELL RD, LOUISVILLE, KY 40205-2309
(502) 454-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
32450
KY
207Q00000X
Family Medicine Physician
32450
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000546227
ANTHEM - NORTON
KY
01
—
00533022
MEDICARE - NORTON
KY
01
—
009583
SIHO - NORTON
KY
01
—
P00612408
RAILROAD MEDICARE
KY
Enumeration date
04/12/2007
Last updated
08/10/2017
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