Individual
MARY LOU G REICHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6041 TIMBER RIDGE DR, PROSPECT, KY 40059-8134
(502) 928-0910
(502) 928-0911
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4900
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21498
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64214984
—
KY
Enumeration date
10/03/2006
Last updated
02/11/2020
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