Individual
DR. CAROLYN BANKS GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
127 FAIRFAX AVE, LOUISVILLE, KY 40207-4905
(502) 890-3899
(502) 384-8883
Mailing address
127 FAIRFAX AVE, LOUISVILLE, KY 40207-4905
(502) 890-3899
(502) 384-8883
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
25213
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001065181
ANTHEM
KY
Enumeration date
11/28/2006
Last updated
04/23/2019
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