Individual
DALE SENIOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9880 ANGIES WAY, STE. 410, LOUISVILLE, KY 40241-2851
(502) 891-8300
(502) 891-8668
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
27888
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64278880
—
KY
Enumeration date
01/10/2006
Last updated
01/21/2021
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