Individual
ANTHONY GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2909 PRESTON HWY, LOUISVILLE, KY 40217
(502) 635-6321
(502) 637-6386
Mailing address
PO BOX 22584, LOUISVILLE, KY 40252-0584
(954) 465-3569
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14145
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000077695
ANTHEM
KY
01
—
100359720B
INDIANA EDS
IN
01
—
1127719
PASSPORT
KY
05
—
64141450
—
KY
Enumeration date
12/13/2006
Last updated
10/03/2019
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