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Individual

DR. DAISY SANGROULA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202
(502) 852-5851
(502) 852-3762
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0330

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301092207
MI
207L00000X
Anesthesiology Physician
Primary
43890
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201177140
IN
01
43890
LICENSE
KY
05
7100236170
KY
01
K077070
MEDICARE
KY
Enumeration date
07/06/2009
Last updated
11/01/2018
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