Individual
DR. THOMAS EDWARD MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9905 SHELBYVILLE RD, LOUISVILLE, KY 40223-2907
(502) 425-5166
(502) 327-0526
Mailing address
9905 SHELBYVILLE RD, LOUISVILLE, KY 40223-2907
(502) 425-5166
(502) 327-0526
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
26121
KY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
26121
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64261217
—
KY
Enumeration date
09/13/2005
Last updated
09/13/2017
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