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Individual

THOMAS M MORIARTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD PHD

Contact information

Practice address
210 E GRAY ST, SUITE 1105, LOUISVILLE, KY 40202-3900
(502) 583-1609
(502) 583-2120
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
33517
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000604406
ANTHEM - NNIKY
KY
01
000023035H
HUMANA - NNIKY
KY
01
00533112
MEDICARE - KY - NNIKY
KY
01
102716
SIHO - NNIKY
KY
05
200155550
IN
01
3694171000
PASSPORT ADVTG - NNIKY
KY
01
50022352
PASSPORT - NNIKY
KY
05
64353170
KY
01
7354921
CIGNA - NNIKY
KY
Enumeration date
08/24/2005
Last updated
07/13/2016
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