Organization
CHIAKI GAUNTT MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA M APPLEGATE COT (PRACTICE ADMINISTRATOR)
(502) 645-8539
Entity
Organization
Contact information
Practice address
1917 S HIGHWAY 53, LA GRANGE, KY 40031-8574
(502) 645-8539
(812) 944-5496
Mailing address
6307 MINT SPRING BRANCH RD, PROSPECT, KY 40059-8614
(502) 645-8539
(812) 944-5496
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
39795
KY
Other
Enumeration date
10/24/2007
Last updated
04/30/2008
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