Individual
JOHN M MANDROLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 KRESGE WAY, SUITE 60, LOUISVILLE, KY 40207
(502) 893-7710
(502) 893-1391
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
32628
KY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
32628
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200060360A
—
IN
05
—
200060360F
—
IN
05
—
64326283
—
KY
Enumeration date
07/07/2006
Last updated
12/11/2020
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