Organization
T. GERALD O'DANIEL M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. T. GERALD O'DANIEL M.D., PLLC (SOLE PROPRIETOR)
(502) 584-1109
Entity
Organization
Contact information
Practice address
222 S 1ST ST, SUITE 100, LOUISVILLE, KY 40202-1350
(502) 584-1109
(502) 589-6882
Mailing address
222 S 1ST ST, SUITE 100, LOUISVILLE, KY 40202-1350
(502) 584-1109
(502) 589-6882
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
24070
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000219660
ANTHEM PIN
KY
01
—
002
CIGNA
KY
05
—
100033340A
—
IN
01
—
1058697
PASSPORT PIN
KY
05
—
64240708
—
KY
01
—
667357
HEALTHLINK
KY
01
—
KY0057799
TRICARE
KY
01
—
KY1118
HEALTHNET
KY
Enumeration date
01/31/2007
Last updated
10/28/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us