Individual
LISA DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 899-7646
Mailing address
PO BOX 6749, LOUISVILLE, KY 40206-0749
(502) 899-7646
(502) 899-7648
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25879
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049540
BLUE CROSS FACET ID
KY
Enumeration date
09/13/2006
Last updated
08/04/2010
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