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Individual

ANTOLIN JULIAN PEREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
727 HOSPITAL DR, SHELBYVILLE, KY 40065-1660
(502) 647-4085
(502) 647-4098
Mailing address
308 LONGVIEW PARK PL, LOUISVILLE, KY 40245-6217
(502) 489-9472

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28835
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200902390A
IN
05
7100046920
KY
Enumeration date
10/27/2006
Last updated
05/01/2019
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