Individual
ANGELINO S YSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4003 KRESGE WAY, SUITE 400, LOUISVILLE, KY 40207-4652
(502) 895-4263
(502) 899-5488
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 253-1035
(502) 253-1037
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
27613
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000575262
ANTHEM - NCMA
KY
01
—
000000614192
ANTHEM - NMA
KY
01
—
000023033Q
HUMANA
KY
01
—
00533053
MEDICARE - KY - NMA
KY
01
—
097760
SIHO
KY
01
—
0994672
CIGNA - NMA
KY
01
—
200035830
MEDICAID-IN - NMA
IN
05
—
2432738000
—
KY
01
—
3534949000
PASSPORT ADVTG - NMA
KY
01
—
3759061000
PASSPORT ADVTG - NCMA
KY
01
—
50027043
PASSPORT - NCMA
KY
01
—
5020165
PASSPORT - NMA
KY
01
—
64276132
MEDICAID-KY - NMA
KY
05
—
64276132
—
KY
01
—
P00655716
RAILROAD MCR - NMA
KY
Enumeration date
05/22/2006
Last updated
12/01/2020
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