Individual
DR. JAMES E MCKIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 KRESGE WAY, SUITE 56, LOUISVILLE, KY 40207-4660
(502) 895-7265
(502) 897-2113
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 238-2801
(502) 238-2835
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
18531
KY
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
18531
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000617819
ANTHEM
KY
05
—
100373820
—
IN
01
—
1049109
PASSPORT
KY
01
—
2432390000
PASSPORT ADVANTAGE
KY
05
—
64185317
—
KY
01
—
P00719572
RAILTOAD MEDICARE
KY
Enumeration date
12/28/2005
Last updated
12/13/2013
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