Individual
DOUGLAS OWEN PEENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3999 DUTCHMANS LN, SUITE 4D, LOUISVILLE, KY 40207-4729
(502) 893-6777
(502) 899-5535
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
207VG0400X
Gynecology Physician
Primary
19315
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051305
PASSPORT
KY
01
—
2623
BLUE CROSS
KY
05
—
64193154
—
KY
Enumeration date
07/28/2006
Last updated
04/15/2016
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