Individual
PAUL R. MAGIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, ANESTHESIA DEPARTMENT, LOUISVILLE, KY 40202-2877
(502) 587-4203
(502) 587-4155
Mailing address
100 E LIBERTY ST, SUITE 800, LOUISVILLE, KY 40202-1434
(502) 587-4044
(502) 479-1425
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3000344
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200018890A
—
IN
05
—
74289174
—
KY
Enumeration date
12/05/2006
Last updated
12/01/2015
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